Effects of lacidipine on peak oxygen consumption, neurohormones and invasive haemodynamics in patients with mild to moderate chronic heart failure.
OBJECTIVE
To evaluate the efficacy and safety of the second generation dihydropyridine calcium channel blocker lacidipine in patients with heart failure.


METHODS
Placebo controlled, parallel group, double blind study over 8 weeks.


METHODS
General community hospital in Breda, The Netherlands.


METHODS
A random sample was studied of 25 outpatients with symptoms of mild to moderate heart failure, despite treatment with diuretics, digoxin, and angiotensin converting enzyme inhibitors. Their mean age was 65 years, with mean left ventricular ejection fraction of 0.24 and a peak oxygen consumption of 14.4 ml/min/kg. Two patients dropped out on lacidipine, one patient on placebo.


METHODS
Treatment with lacidipine 4 mg once daily or placebo for eight weeks.


METHODS
Cardiopulmonary exercise testing, invasive haemodynamics, and plasma neurohormones.


RESULTS
Treatment with lacidipine 4 mg once daily, as compared to placebo treatment, significantly improved peak oxygen consumption (P < 0.02), cardiac index (P < 0.01), and stroke volume (P < 0.03) paralleled by a decrease in systemic vascular resistance (P < 0.03) and arteriovenous oxygen content difference (P < 0.01). Plasma noradrenaline, plasma renin activity, and aldosterone values did not differ between lacidipine and placebo.


CONCLUSIONS
This second generation dihydropyridine may be of value as an adjunct to standard treatment in congestive heart failure patients.
de Vries
R J
RJ
Department of Cardiology/Thoraxcenter, University Hospital Groningen, Netherlands.
Dunselman
P H
PH
Chin Kon Sung
U G
UG
van Veldhuisen
D J
DJ
Corbeij
H M
HM
van Gilst
W H
WH
Lie
K I
KI
D000368:Aged; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004077:Digoxin / Q000627:therapeutic use; D004095:Dihydropyridines / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010101:Oxygen Consumption / Q000187:drug effects*; D011446:Prospective Studies; D012083:Renin / Q000097:blood; D013318:Stroke Volume / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D004232:Diuretics; C060285:lacidipine; D000450:Aldosterone; D004077:Digoxin; D012083:Renin; D009638:Norepinephrine