CHRONIC EFFECTS OF NIFEDIPINE IN PATIENTS WITH REFRACTORY HEART-FAILURE

This study was designed to investigate the chronic effects of nifedipine on refractory heart failure. Twenty-five patients with grade III or higher heart failure, according to the New York Heart Association classification system, were enrolled in the study. Eleven patients had regurgitant valvular disease, 3 had stenotic valvular disease, and 11 had other cardiac diseases. Improvement was judged by the patients' overall scores, which were calculated from the sum of the scores of subjective and objective symptoms and hemodynamic parameters before and after 1 month of nifedipine 30 mg/day therapy. The percent of patients who experienced unchanged, moderate, or substantial improvement was 9%, 55%, and 27% of those with regurgitant valvular disease; 0%, 36%, and 64% of those with other cardiac diseases; 27%, 18%, and 55% of those with grade IV heart failure; and 14%, 57%, and 29% of those with grade III heart failure, respectively. All 3 patients with stenotic valvular disease and 7 of the 11 patients with regurgitant valvular disease underwent surgery. Two of the 3 patients with stenotic valvular disease died, as did 2 of the 11 patients with regurgitant valvular disease and 1 of the 11 patients with other cardiac diseases. Thus the long-lasting efficacy of nifedipine on refractory heart failure remains unknown.