Felodipine in ventricular dysfunction

The systemic and coronary haemodynamic effects of felodipine were evaluated at rest and during stress induced atrial pacing in fourteen patients with chronic cardiac failure, secondary to coronary heart disease. Felodipine was an effective arteriolar vasodilator producing increases in cardiac index from 2.6 +/- 0.1 to 3.5 +/- 0.2 l min-1 m-2 (P less than 0.001) and stroke volume 35.3 +/- 2.7 to 41.4 +/- 2.4 ml beat-1 m-2 (P less than 0.002). Coronary venous flow also increased significantly (126 +/- 8 to 168 +/- 13 ml min-1) (P less than 0.005) and this did not appear to be accompanied by an increase in myocardial oxygen usage, as myocardial oxygen consumption was essentially unchanged. When the myocardium was stressed by atrial pacing the increase in cardiac output and stroke volume was maintained--25% and 23%, respectively (P less than 0.01). These results suggest that felodipine may well have a significant role in the management of patients with congestive cardiac failure.