caa a22 4500 477056865 CHVBK 20180405111348.0 cr unu---uuuuu 170330e19961001xx s 000 0 eng 10.1007/s002280050173 doi (NATIONALLICENCE)springer-10.1007/s002280050173 Flosequinan in chronic heart failure: how is exercise capacity improved? [Elektronische Daten] [A. P. Banning, M. W. Ramsey, E. A. Jones, W. Evans, G. Carolan, C. H. Jones, A. H. Henderson] Objective: Diuretics, angiotensin converting enzyme inhibitors and digoxin have become "standard” triple therapy for many patients with chronic cardiac failure. Flosequinan increases exercise duration and improves symptoms when added to standard triple therapy. Despite intensive study, the clinical pharmacology of flosequinan remains uncertain. Setting: The University Hospital of Wales, a Regional Cardiac Centre. Patients: Twenty four patients with chronic heart failure who remained symptomatic despite standard therapy including ACE inhibitors Methods: A double-blind placebo-controlled parallel group study of 100 mg daily of flosequinan. We measured changes in exercise duration using cardiorespiratory exercise testing and changes in large artery distensibility using Doppler ultrasound. Results: Exercise duration after 8 weeks flosequinan treatment was significantly greater than following placebo treatment. The flosequinan-related increase in exercise duration (+14%) was associated with a significant reduction in VE/VCO2 slope (−16%). Brachial-radial pulse wave velocities were unaltered by flosequinan treatment. Conclusions: Our results confirm that flosequinan improves exercise duration in patients with chronic heart failure. They suggest that this observed beneficial effect is independent of any change in large artery distensibility and that in the presence of ACE inhibitors, this improvement may be independent of any vasodilating action of flosequinan. Although this study confirms the beneficial symptommatic effects of flosequinan in chronic cardiac failure, clinical trials have subsequently demonstrated an overall increase in mortality in patients treated with 100 mg flosequinan daily. This has resulted in the withdrawl of flosequinan from routine clinical use. Springer-Verlag Berlin Heidelberg, 1996 Key words Flosequinan nationallicence Heart failure nationallicence ACE inhibitor nationallicence vasodilatation nationallicence exercise capacity nationallicence Banning A. P. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Ramsey M. W. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Jones E. A. Department of Bioengineering and Medical Physics, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Evans W. Department of Bioengineering and Medical Physics, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Carolan G. Department of Bioengineering and Medical Physics, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Jones C. H. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Henderson A. H. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut https://doi.org/10.1007/s002280050173 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050173 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Banning A. P. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Ramsey M. W. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Jones E. A. Department of Bioengineering and Medical Physics, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Evans W. Department of Bioengineering and Medical Physics, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Carolan G. Department of Bioengineering and Medical Physics, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Jones C. H. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Henderson A. H. Department of Cardiology, University of Wales College of Medicine, Heath Park, Cardiff, CF4 4XN, UK, GB aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer