Congestive heart failure calcium channel blockers

Jump to: navigation, search
Siren.gif

Resident
Survival
Guide
88px

Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure calcium channel blockers On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Congestive heart failure calcium channel blockers

CDC on Congestive heart failure calcium channel blockers

Congestive heart failure calcium channel blockers in the news

Blogs on Congestive heart failure calcium channel blockers

Directions to Hospitals Treating Congestive heart failure calcium channel blockers

Risk calculators and risk factors for Congestive heart failure calcium channel blockers

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Although calcium channel blockers cause vasodilation and may reduce afterload in the setting of heart failure, their overall benefit in heart failure is minimized by the fact that they have a negative inotropic effect and by the reflex activation of the sympathetic nervous system. These agents are therefore not recommended as vasodilators in patients with systolic dysfunction,however they may be useful as antihypertensive agents in patients with diastolic dysfunction.

2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) [1][2]

Calcium channel blockers in Patients Presenting With Heart Failure (DO NOT EDIT) [1][2]

Class I
"1. Drugs known to adversely affect the clinical status of patients with current or prior symptoms of heart failure and reduced left ventricular ejection fraction (LVEF) should be avoided or withdrawn whenever possible (e.g., nonsteroidal anti-inflammatory drugs, most antiarrhythmic drugs, and most calcium channel blocking drugs.[3][4][5][6][7][8][9] (Level of Evidence: B) "
Class III (No Benefit)
"1. Calcium channel blocking drugs are not indicated as routine treatment for heart failure in patients with current or prior symptoms of heart failure and reduced left ventricular ejection fraction (LVEF). [10][11][12][13] (Level of Evidence: A) "

Vote on and Suggest Revisions to the Current Guidelines

External Links

References

  1. 1.0 1.1 1.2 Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202
  2. 2.0 2.1 2.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016. DOI:10.1161/CIRCULATIONAHA.109.192064 PMID: 19324967
  3. Heerdink ER, Leufkens HG, Herings RM, Ottervanger JP, Stricker BH, Bakker A (1998). "NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics". Archives of Internal Medicine. 158 (10): 1108–12. PMID 9605782. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  4. Herchuelz A, Derenne F, Deger F, Juvent M, Van Ganse E, Staroukine M, Verniory A, Boeynaems JM, Douchamps J (1989). "Interaction between nonsteroidal anti-inflammatory drugs and loop diuretics: modulation by sodium balance". The Journal of Pharmacology and Experimental Therapeutics. 248 (3): 1175–81. PMID 2703968. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  5. Gottlieb SS, Robinson S, Krichten CM, Fisher ML (1992). "Renal response to indomethacin in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy". The American Journal of Cardiology. 70 (9): 890–3. PMID 1529943. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  6. Bank AJ, Kubo SH, Rector TS, Heifetz SM, Williams RE (1991). "Local forearm vasodilation with intra-arterial administration of enalaprilat in humans". Clinical Pharmacology and Therapeutics. 50 (3): 314–21. PMID 1655327. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  7. "Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators". The New England Journal of Medicine. 321 (6): 406–12. 1989. doi:10.1056/NEJM198908103210629. PMID 2473403. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  8. "Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators". The New England Journal of Medicine. 327 (4): 227–33. 1992. doi:10.1056/NEJM199207233270403. PMID 1377359. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  9. Pratt CM, Eaton T, Francis M, Woolbert S, Mahmarian J, Roberts R, Young JB (1989). "The inverse relationship between baseline left ventricular ejection fraction and outcome of antiarrhythmic therapy: a dangerous imbalance in the risk-benefit ratio". American Heart Journal. 118 (3): 433–40. PMID 2476016. Retrieved 2012-04-05. Unknown parameter |month= ignored (help)
  10. "The effect of diltiazem on mortality and reinfarction after myocardial infarction. The Multicenter Diltiazem Postinfarction Trial Research Group". The New England Journal of Medicine. 319 (7): 385–92. 1988. doi:10.1056/NEJM198808183190701. PMID 2899840. Retrieved 2012-04-06. Unknown parameter |month= ignored (help)
  11. Reed SD, Friedman JY, Velazquez EJ, Gnanasakthy A, Califf RM, Schulman KA (2004). "Multinational economic evaluation of valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT)". American Heart Journal. 148 (1): 122–8. doi:10.1016/j.ahj.2003.12.040. PMID 15215801. Retrieved 2012-04-06. Unknown parameter |month= ignored (help)
  12. Setaro JF, Zaret BL, Schulman DS, Black HR, Soufer R (1990). "Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance". The American Journal of Cardiology. 66 (12): 981–6. PMID 2220622. Retrieved 2012-04-06. Unknown parameter |month= ignored (help)
  13. Packer M, O'Connor CM, Ghali JK, Pressler ML, Carson PE, Belkin RN, Miller AB, Neuberg GW, Frid D, Wertheimer JH, Cropp AB, DeMets DL (1996). "Effect of amlodipine on morbidity and mortality in severe chronic heart failure. Prospective Randomized Amlodipine Survival Evaluation Study Group". The New England Journal of Medicine. 335 (15): 1107–14. doi:10.1056/NEJM199610103351504. PMID 8813041. Retrieved 2012-04-06. Unknown parameter |month= ignored (help)



Linked-in.jpg