title: Disparity between improvement in left ventricular function and changes in clinical status and exercise capacity during chronic enoximone therapy.
abstract: Twenty patients with moderately severe congestive heart failure were randomized to chronic enoximone (n = 10) or placebo (n = 10) therapy in a double-blind manner and serially evaluated over a 16-week-period. The purpose of the study was to determine if the addition of standard doses (1 and 2 mg/kg) of this new phosphodiesterase inhibitor to conventional therapy (digitalis and diuretics) would alter the clinical and laboratory course of this patient population. Except for a transient improvement in the quality of life score, none of the symptomatology indicators were significantly affected by enoximone. Similarly, maximal exercise capacity was not altered. Enoximone did elicit a statistically significant augmentation of echocardiographic, radionuclide angiographic, and systolic time interval parameters of left ventricular function. These enoximone-induced effects were accompanied by a significant increase (7% to 11%) in resting heart rate. Enoximone is capable of improving ventricular function when added to digitalis-diuretic therapy in moderately severe congestive heart failure. While individual patients may benefit from enoximone, the ability of standard doses of this agent to improve symptoms and exercise capacity over a 16-week period appears somewhat limited in a moderately severe heart failure population as a whole. Furthermore, a disparity between improvement in ventricular function parameters and changes in clinical status and exercise performance is apparent in this heart failure population.
authors.affiliation: Division of Cardiology, Ohio State University College of Medicine, Columbus 43210.
authors.forename: C V
authors.initials: CV
authors.lastname: Leier
authors.forename: P F
authors.initials: PF
authors.lastname: Binkley
authors.forename: R C
authors.initials: RC
authors.lastname: Starling
authors.forename: P
authors.initials: P
authors.lastname: Huss-Randolph
mesh_terms: D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D004070:Digitalis; D004232:Diuretics / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D017335:Enoximone; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010946:Plants, Medicinal; D010947:Plants, Toxic; D011897:Random Allocation
chemical_list: D004232:Diuretics; D007093:Imidazoles; D017335:Enoximone