The effects of flosequinan on submaximal exercise in patients with chronic cardiac failure.

Abstract

1. Twenty patients with moderate to severe chronic cardiac failure were entered into a double‐blind parallel group study comparing flosequinan 100 mg daily with matching placebo. 2. After at least three prior exercise tests, cardiopulmonary parameters were assessed at rest and during submaximal exercise before and after 2 and 8 weeks of active drug or placebo. 3. Resting minute ventilation and respiratory rate were reduced by flosequinan compared with placebo, but oxygen uptake was unchanged. 4. Comparison of minute ventilation, carbon dioxide production and venous lactate levels at the end of the exercise stage approximating to 50% of peak oxygen uptake demonstrated significant reductions in the flosequinan group compared with placebo at week 2 and week 8 (P less than 0.05). 5. Flosequinan increased the oxygen uptake at anaerobic threshold from 13.2 +/− 2.8 ml min‐1 kg‐1 to 15.9 +/− 3.4 ml min‐1 kg‐1 at week 2 and 15.8 +/− 3.7 ml min‐1 kg‐1 at week 8. These increases were significant when compared with placebo (P less than 0.05). 6. We conclude that flosequinan improves submaximal exercise performance in patients with chronic cardiac failure, probably by enhancing skeletal muscle blood flow.

Effect of flosequinan on exercise capacity and cardiac function in patients with chronic mild heart failure: A double-blind placebo-controlled study

“…The reasons for this discrepancy are unclear. However, Elborn et al [9,10] also demonstrated that the peak oxygen uptake increased only by 13% whereas an increase in anaerobic threshold (20%) was larger. Thus, the drug may preferentially improve the anaerobic threshold.…”

“…1). In severe heart failure, Elborn et al [9,10] demonstrated significant improvements in these measurements after 8 weeks' administration of flosequinan, at 100mg daily, compared to placebo treatment in a similarily designed double-blind study. The difference between our results and theirs may be attributed to the difference in the severity of heart failure.…”

“…In single dose and short-term administration, flosequinan has been reported to improve resting hemodynamics in patients with chronic heart failure [5][6][7]. This drug has been also reported to increase the exercise time, peak oxygen uptake and anaerobic threshold with short-term administration in patients with severe heart failure [8][9][10]. Thus the drug appears to be promising as a vasodilator which can promptly improve exercise capacity.…”