The systemic and coronary haemodynamic effects of felodipine in patients with coronary heart disease

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Abstract
The cardiovascular effects of felodipine, a new arteriolar vasodilator, were studied in 22 patients with coronary heart disease. There were significant falls in blood pressure and systemic vascular resistance of 16 and 38% respectively (P = 0.001), thus affecting after-load. Cardiac index and stroke index increased by 35 and 12% respectively. There was reflex tachycardia-from 75 ±3 to 85 ±3 b.p.m. (P =0.005). Coronary sinus blood /low increased from 134±9 to 191 ±17 ml/min (P<0.005) and myocardial arterio- venous oxygen difference narrowed from 12.l±0.5 to 9.0±0.4 vols% (P<0.001) indicating less oxygen usage. With the heart rate held constant by atrial pacing, cardiac index and stroke index increased by 30 and 26% (P<0.001), whilst systolic blood pressure and systemic vascular resistance fell by 20 and 29% (P<0.001). This would suggest that the improved haemodynamics were largely secondary to after-load reduction.

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