TY - JOUR
T1 - Sustained hemodynamic response to flosequinan in patients with heart failure receiving angiotensin-converting enzyme inhibitors
AU - Gottlieb, Stephen S.
AU - Kukin, Marrick L.
AU - Penn, Joshua
AU - Fisher, Michael L.
AU - Cines, Michelle
AU - Medina, Norma
AU - Yushak, Madeline
AU - Taylor, Mary
AU - Packer, Milton
PY - 1993/10
Y1 - 1993/10
N2 - Objectives. We evaluated the short- and long-term effects of flosequinan in 47 patients with severe heart failure despite ongoing captopril treatment. Background. There have been no previous evaluations of the long-term hemodynamic effects of any direct-acting vasodilator in patients with heart failure receiving an angiotensin-converting enzyme inhibitor. Flosequinan is an arterial and venous vasodilator with actions similar to those of the hydralazine-isosorbide dinitrate combination. Methods. After baseline hemodynamic measurements using balloon-tipped pulmonary artery and radial arterial catheters, patients were randomized to receive 50, 100 or 150 mg of flosequinan daily. Hemodynamic variables were measured immediately before and after short-term flosequinan administration and after 8 weeks of therapy. Results. With short-term flosequinan administration, mean arterial, right atrial and left ventricular filling pressures decreased by 6.4 ± 1.1, 3.8 ± 0.5 and 7.3 ± 0.7 mm Hg, respectively (all p < 0.001). Cardiac index increased by 0.5 ± 0.1 liters/min per m2, systemic vascular resistance decreased by 616 ± 105 dynes · s · cm-5 and heart rate increased by 4 ± l beats/min (all p < 0.001). After 8 weeks of long-term flosequinan administration, the vasodilator effect of a dose of flosequinan persisted. Compared with pretreatment baseline values, mean arterial, right atrial and left ventricular filling pressures at the peak effect of flosequinan were decreased by 3.5 ± 1.3, 2.8 ± 0.7 and 5.1 ± 1.3 mm Hg, respectively (all p < 0.01). Systemic vascular resistance had decreased by 585 ± 95 dynes · s · cm-5, cardiac index had increased by 0.5 ± 0.1 liters/mn per m2 and heart rate had increased by 10 ± 2 beats/min (all p < 0.001). Conclusions. The arterial and venous vasodilator flosequinan exerts both short- and long-term sustained hemodynamic effects in patients with heart failure receiving angiotensin-converting enzyme inhibitors.
AB - Objectives. We evaluated the short- and long-term effects of flosequinan in 47 patients with severe heart failure despite ongoing captopril treatment. Background. There have been no previous evaluations of the long-term hemodynamic effects of any direct-acting vasodilator in patients with heart failure receiving an angiotensin-converting enzyme inhibitor. Flosequinan is an arterial and venous vasodilator with actions similar to those of the hydralazine-isosorbide dinitrate combination. Methods. After baseline hemodynamic measurements using balloon-tipped pulmonary artery and radial arterial catheters, patients were randomized to receive 50, 100 or 150 mg of flosequinan daily. Hemodynamic variables were measured immediately before and after short-term flosequinan administration and after 8 weeks of therapy. Results. With short-term flosequinan administration, mean arterial, right atrial and left ventricular filling pressures decreased by 6.4 ± 1.1, 3.8 ± 0.5 and 7.3 ± 0.7 mm Hg, respectively (all p < 0.001). Cardiac index increased by 0.5 ± 0.1 liters/min per m2, systemic vascular resistance decreased by 616 ± 105 dynes · s · cm-5 and heart rate increased by 4 ± l beats/min (all p < 0.001). After 8 weeks of long-term flosequinan administration, the vasodilator effect of a dose of flosequinan persisted. Compared with pretreatment baseline values, mean arterial, right atrial and left ventricular filling pressures at the peak effect of flosequinan were decreased by 3.5 ± 1.3, 2.8 ± 0.7 and 5.1 ± 1.3 mm Hg, respectively (all p < 0.01). Systemic vascular resistance had decreased by 585 ± 95 dynes · s · cm-5, cardiac index had increased by 0.5 ± 0.1 liters/mn per m2 and heart rate had increased by 10 ± 2 beats/min (all p < 0.001). Conclusions. The arterial and venous vasodilator flosequinan exerts both short- and long-term sustained hemodynamic effects in patients with heart failure receiving angiotensin-converting enzyme inhibitors.
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U2 - 10.1016/0735-1097(93)90404-O
DO - 10.1016/0735-1097(93)90404-O
M3 - Article
C2 - 8409070
AN - SCOPUS:0027490096
SN - 0735-1097
VL - 22
SP - 963
EP - 967
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -