ENOXIMON ECHOCARDIOGRAPHY - A NEW DIAGNOSTIC-APPROACH FOR THE DETECTION OF VIABLE MYOCARDIUM COMPARISON TO DOBUTAMIN ECHOCARDIOGRAPHY

Hypo- or akinetic myocardial regions can be identified as viable myoca rdium through recruitment of inotropic reserve. Both, dobutamine (D) a s well as enoximone (E) mediate their inotropic action via an increase in intracellular c-AMP concentration based on a different action. In 10 patients with documented myocardial infarction either D (5 to 40 mu g/kg/min, increments of 5 mug/kg/min every 3 min) or E (1 to 9 mug/kg/ min, increments of 1 mug/kg/min every 2 min) was administered intraven ously on two consecutive days. Heart rate (HR), systolic and diastolic blood pressure (BP), as well as a wall motion score in 16 segments (W MS) and ejection fraction (EF) with 2D-echocardiography were determine d at rest and during each increment. Viability of myocardial regions w as assessed with thallium-201-SPECT (Table 1). Results: p < 0.05 vs. rest, data: mean +/- SD While E did not cause any side effects, patien ts complained about rash (n = 10), headache (n = 8), angina pectoris ( n = 5), and anxiety (n = 2) during the administration of D. D and E ar e both able to recruit a potential inotropic reserve in infarcted myoc ardium, and thus, identify viable myocardium. In contrast to E, D caus ed an increase in HR and systolic BP. Enoximone-echocardiography seems to be a new, promising tool for the identification of viable myocardi um. [GRAPHICS]