EFFECTS OF AMLODIPINE IN PATIENTS WITH CHRONIC HEART-FAILURE

The role of calcium antagonists inpatients with ischemic heart failure is currently unclear. We examined the effects of amlodipine on exerci se capacity and central and regional hemodynamics in 32 patients with mild to moderate chronic heart Failure in a single-center, double-blin d; randomized placebo-controlled trial. All were taking at least 40 mg of furosemide daily with an angiotensin-converting enzyme inhibitor. Ischemic heart disease was the most common cause of heart Failure, but no patient had symptom-limiting angina. Mean treadmill exercise capac ity in patients taking amlodipine increased by 96 seconds (95% confide nce interval -23 to 215) and 50 seconds (-34 to 135) in the placebo gr oup; mean difference in change between treatments was 70 seconds (-90 to 233), p = 0.38. Active treatment with amlodipine did not affect sel f-paced corridor walking times. Similarly, there were no significant e ffects on cardiac output, oxygen uptake, heart rate, and mean arterial pressure at rest or during exercise. Calf and renal blood flow were a lso unchanged by treatment. The lack of significant effect demonstrate d by these data suggests a limited role for amlodipine in patients wit h ischemic cardiomyopathy, although it may prove beneficial in those w ith nonischemic disease. More data are required before amlodipine can be recommended for all patients with chronic heart failure.