ACUTE AND CHRONIC EFFECTS OF FLOSEQUINAN ON RESTING AND EXERCISE HEMODYNAMICS IN CONGESTIVE-HEART-FAILURE

1 The acute and chronic (8 weeks) haemodynamic responses to oral flose quinan have been investigated in 12 male patients of mean age 58.9 yea rs with congestive heart failure of N.Y.H.A. classes II and III. 2 Flo sequinan 125 mg orally significantly reduced right atrial pressure, pu lmonary artery pressure and pulmonary wedge pressure prior to and foll owing 8 weeks chronic treatment (125 mg daily). A significant decrease in systemic pressure and an increase in heart rate were also observed with acute flosequinan prior to chronic treatment. A reduction in sys temic vascular resistance and an increase in cardiac index reached sig nificance in response to flosequinan 125 mg orally following 8 weeks o f therapy. 3 In the erect position, flosequinan reduced pulmonary wedg e pressure and tended to reduce systemic vascular resistance, without decreasing mean arterial pressure. 4 Following chronic treatment, ther e was a trend towards a reduction in pulmonary wedge pressure and an i ncrease in cardiac index, otherwise resting and exercise haemodynamics were unchanged. 5 The response to flosequinan was similar at week 1 a nd after 8 weeks of treatment for all of the haemodynamic parameters. 6 Flosequinan increased bicycle exercise times and attenuated exercise -induced increases in pulmonary arterial and systemic pressures. There was a trend towards an increase in treadmill exercise time. 7 Subling ual glyceryl trinitrate (0.5 mg) and oral flosequinan (125 mg) had sim ilar effects on right atrial pressure, pulmonary arterial and pulmonar y wedge pressures at 5 min and 2 h respectively post-dosing. A small a dditive effect on pulmonary arterial and wedge pressures was observed.