Effects of enoximone on peripheral and central chemoreflex responses in humans.
cAMP plays an important role in peripheral chemoreflex function in animals. We tested the hypothesis that the phosphodiesterase inhibitor and inotropic medication enoximone increases peripheral chemoreflex function in humans. In a single-blind, randomized, placebo-controlled crossover study of 15 men, we measured ventilatory, muscle sympathetic nerve activity, and hemodynamic responses to 5 min of isocapnic hypoxia, 5 min of hyperoxic hypercapnia, and 3 min of isometric handgrip exercise, separated by 1 wk, with enoximone and placebo administration. Enoximone increased cardiac output by 120 +/- 3.7% from baseline (P < 0.001); it also increased the ventilatory response to acute hypoxia [13.6 +/- 1 vs. 11.2 +/- 0.7 l/min at 5 min of hypoxia, P = 0.03 vs. placebo (by ANOVA)]. Despite a larger minute ventilation and a smaller decrease in O(2) desaturation (83 +/- 1 vs. 79 +/- 2%, P = 0.003), the muscle sympathetic nerve response to hypoxia was similar between enoximone and placebo (123 +/- 6 and 117 +/- 6%, respectively, P = 0.28). In multivariate regression analyses, enoximone enhanced the ventilatory (P < 0.001) and sympathetic responses to isocapnic hypoxia. Hyperoxic hypercapnia and isometric handgrip responses were not different between enoximone and placebo (P = 0.13). Enoximone increases modestly the chemoreflex responses to isocapnic hypoxia. Moreover, this effect is specific for the peripheral chemoreflex, inasmuch as central chemoreflex and isometric handgrip responses were not altered by enoximone.
Gujic
Marko
M
Department of Cardiology, Erasme University Hospital, 808 Lennik Road, Brussels, Belgium. marko.gujic@ulb.ac.be
Dreyfuss
Céline
C
Argacha
Jean-François
JF
Beloka
Sofia
S
Adamopoulos
Dionysios
D
Xhaët
Olivier
O
Pathak
Atul
A
van de Borne
Philippe
P
D000328:Adult; D001049:Apnea / Q000503:physiopathology; D002302:Cardiac Output / Q000187:drug effects; D002490:Central Nervous System / Q000187:drug effects* / Q000503:physiopathology; D002628:Chemoreceptor Cells / Q000187:drug effects* / Q000503:physiopathology; D018592:Cross-Over Studies; D017335:Enoximone / Q000008:administration & dosage / Q000494:pharmacology*; D018737:Hand Strength; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology*; D018496:Hyperoxia / Q000503:physiopathology*; D000860:Hypoxia / Q000503:physiopathology*; D007262:Infusions, Intravenous; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects / Q000294:innervation; D017933:Peripheral Nervous System / Q000187:drug effects* / Q000503:physiopathology; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D012123:Pulmonary Ventilation / Q000187:drug effects; D012018:Reflex / Q000187:drug effects*; D016037:Single-Blind Method; D013564:Sympathetic Nervous System / Q000187:drug effects; D013997:Time Factors
D010726:Phosphodiesterase Inhibitors; D017335:Enoximone