TY - JOUR
T1 - Vasodilatation with felodipine in chronic asymptomatic aortic regurgitation
AU - Søndergaard, Lars
AU - Aldershvile, Jan
AU - Hildebrandt, Per
AU - Kelbæk, Henning
AU - Ståhlberg, Freddy
AU - Thomsen, Carsten
PY - 2000/1/1
Y1 - 2000/1/1
N2 - Background: Afterload reduction decreases volume overload on the left ventricle and may thereby delay the need for valve replacement in chronic asymptomatic aortic regurgitation. The aims of this randomized double-blind, placebo-controlled trial were to examine short- and long-term hemodynamic effects of felodipine in chronic asymptomatic aortic regurgitation. Methods: Sixteen patients were randomly assigned to an intravenous infusion of either felodipine 0.3 mg or placebo followed by 3 months' treatment with felodipine 10 mg or placebo orally once daily. Magnetic resonance imaging was performed at baseline, immediately after intravenous treatment, and after 3 months of oral treatment. Results: Intravenous felodipine caused a statistically significant reduction in the systemic vascular resistance from (mean ± SD) 1160 ± 400 to 970 ± 320 dynes · s · cm-5 (P < .05), in the regurgitant volume index from 1.5 ± 0.8 to 1.3 ± 0.8 L · min-1. m-2 (P < .05), and in the regurgitant fraction from 0.31 ± 0.15 to 0.26 ± 0.14 (P < .05). The forward cardiac output index increased significantly from 3.2 ± 0.9 to 3.5 ± 0.7 L · min-1 · m-2 (P < .05). Three months of oral treatment with felodipine caused a corresponding but more pronounced decrease in systemic vascular resistance of 880 ± 330 dynes · s · cm-5 (P < .05), regurgitant volume index of 1.2 ± 0.7 L · min-1 · m-2 (P < .05), and regurgitant fraction 0.25 ± 0.11 (P < .05), whereas the forward cardiac output index increased to 3.6 ± 0.7 L · min-1 · m-2 (P < .05). No significant changes were found in the placebo group. Left ventricular volumes and ejection fraction remained unaffected by treatment, but compared with the placebo group left ventricular myocardial mass decreased significantly from 137 ± 24 to 132 ± 21 g · m-2 (P < .01). Conclusion: In chronic asymptomatic aortic regurgitation, felodipine causes beneficial hemodynamic effects that may postpone the need for valve replacement.
AB - Background: Afterload reduction decreases volume overload on the left ventricle and may thereby delay the need for valve replacement in chronic asymptomatic aortic regurgitation. The aims of this randomized double-blind, placebo-controlled trial were to examine short- and long-term hemodynamic effects of felodipine in chronic asymptomatic aortic regurgitation. Methods: Sixteen patients were randomly assigned to an intravenous infusion of either felodipine 0.3 mg or placebo followed by 3 months' treatment with felodipine 10 mg or placebo orally once daily. Magnetic resonance imaging was performed at baseline, immediately after intravenous treatment, and after 3 months of oral treatment. Results: Intravenous felodipine caused a statistically significant reduction in the systemic vascular resistance from (mean ± SD) 1160 ± 400 to 970 ± 320 dynes · s · cm-5 (P < .05), in the regurgitant volume index from 1.5 ± 0.8 to 1.3 ± 0.8 L · min-1. m-2 (P < .05), and in the regurgitant fraction from 0.31 ± 0.15 to 0.26 ± 0.14 (P < .05). The forward cardiac output index increased significantly from 3.2 ± 0.9 to 3.5 ± 0.7 L · min-1 · m-2 (P < .05). Three months of oral treatment with felodipine caused a corresponding but more pronounced decrease in systemic vascular resistance of 880 ± 330 dynes · s · cm-5 (P < .05), regurgitant volume index of 1.2 ± 0.7 L · min-1 · m-2 (P < .05), and regurgitant fraction 0.25 ± 0.11 (P < .05), whereas the forward cardiac output index increased to 3.6 ± 0.7 L · min-1 · m-2 (P < .05). No significant changes were found in the placebo group. Left ventricular volumes and ejection fraction remained unaffected by treatment, but compared with the placebo group left ventricular myocardial mass decreased significantly from 137 ± 24 to 132 ± 21 g · m-2 (P < .01). Conclusion: In chronic asymptomatic aortic regurgitation, felodipine causes beneficial hemodynamic effects that may postpone the need for valve replacement.
UR - http://www.scopus.com/inward/record.url?scp=0034074926&partnerID=8YFLogxK
U2 - 10.1016/S0002-8703(00)90046-2
DO - 10.1016/S0002-8703(00)90046-2
M3 - Article
C2 - 10740150
AN - SCOPUS:0034074926
SN - 0002-8703
VL - 139
SP - 667
EP - 674
JO - American heart journal
JF - American heart journal
IS - 4
ER -