Document Detail


Clinical and neurohormonal effects of nicardipine hydrochloride in patients with severe chronic heart failure receiving angiotensin-converting enzyme inhibitor therapy.
MedLine Citation:
PMID:  10099034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been proposed that worsening of heart failure with dihydropyridines, such as nicardipine, is related to the activation of the neuroendocrine system. To test this, we evaluated 20 patients with severe heart failure (mean age, 55 +/- 13 years; New York Heart Association functional class III; left ventricular ejection fraction, 18% +/- 8% on maintenance therapy with captopril, digoxin, and diuretics) who were randomized to nicardipine (60 or 90 mg/d) or placebo during a 4-month double-blind protocol. The following measurements were obtained at baseline, monthly, and at 4 months or last follow-up visit: rest and exercise radionuclide ventriculography, maximal treadmill time, 6-minute walking test distance, serum norepinephrine and aldosterone concentrations, and plasma renin activity. During the follow-up period, worsening of heart failure occurred in 6 patients in the nicardipine group and in 2 patients in the placebo group (p = 0.06). The maximal treadmill time for a 6-minute walking distance and exercise radionuclide ejection fraction at the last follow-up visit did not change in patients who did not deteriorate with heart failure in the placebo or nicardipine groups as compared with baseline values. In this study group of patients with severe heart failure receiving therapy with digoxin, captopril, and diuretics, nicardipine was associated with worsening heart failure without an apparent activation of the neurohormones. However, because of the small number of patients and a significant number of patients who deteriorated during the follow-up period, no definitive conclusions can be made.
Authors:
D Benatar; V Hall; S Reddy; M Gheorghiade
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of therapeutics     Volume:  5     ISSN:  1075-2765     ISO Abbreviation:  Am J Ther     Publication Date:  1998 Jan 
Date Detail:
Created Date:  2000-01-31     Completed Date:  2000-01-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  25-32     Citation Subset:  IM    
Affiliation:
Northwestern University Medical School, Division of Cardiology, 250 East Superior Street, Wesley 524, Chicago, IL 60611, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Calcium Channel Blockers / therapeutic use*
Captopril / therapeutic use*
Cardiotonic Agents / therapeutic use
Digoxin / therapeutic use
Disease Progression
Diuretics / therapeutic use
Double-Blind Method
Drug Therapy, Combination
Exercise Test
Female
Heart Failure / blood,  classification,  diagnosis,  drug therapy*
Humans
Male
Middle Aged
Neurosecretory Systems / drug effects*
Nicardipine / therapeutic use*
Norepinephrine / blood
Renin / blood
Severity of Illness Index
Stroke Volume / drug effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Calcium Channel Blockers; 0/Cardiotonic Agents; 0/Diuretics; 20830-75-5/Digoxin; 51-41-2/Norepinephrine; 52-39-1/Aldosterone; 55985-32-5/Nicardipine; 62571-86-2/Captopril; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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