Long-term enoximone therapy in unstable chronic heart failure.
Long-term safety and efficacy of oral enoximone were evaluated in 32 patients with unstable chronic heart failure despite digitalis, diuretics, and vasodilator therapy. Oral enoximone, 75-150 mg t.i.d. was given for an average of 32 weeks. At baseline, 21 patients were in NYHA functional class IV, 10 patients in class III, and 1 patient in class II. Within 12 weeks, 14 of 20 patients surviving for more than 26 weeks had improved by at least one functional class. Hemodynamic data showed an 18% increase of cardiac index and a 34% decrease of diastolic pulmonary artery pressure. Echocardiographic recordings revealed an increase of fractional shortening from 13.9 +/- 7 to 15.6 +/- 5% after 12 weeks and 20.3 +/- 5% after 26 weeks. The 1-year survival rate was 40%. Sudden death occurred in three patients and pump failure in 11 patients. No serious side effects were reported. Holter monitoring did not show a significant proarrhythmic drug effect. Thus, long-term enoximone therapy is safe and produces sustained clinical and functional improvement in unstable chronic heart failure. However, overall survival appears not to be influenced in this patient group.
Treese
N
N
II Medical Clinic, Johannes Gutenberg University, Mainz, F.R.G.
Rhein
S
S
Erbel
R
R
Meyer
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004562:Electrocardiography; D017335:Enoximone; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D002316:Cardiotonic Agents; D007093:Imidazoles; D017335:Enoximone