EFFECTS OF ENOXIMONE ON RIGHT-VENTRICULAR FUNCTION IN PATIENTS WITH IMPAIRED MYOCARDIAL PERFORMANCE

The effects of an enoximone monotherapy on left-ventricular and especi ally on right-ventricular haemodynamics were investigated in fourteen patients with impaired left-ventricular function secondary to coronary artery disease. Anaesthesia was induced and maintained with fentanyl and flunitrazepam. After reaching steady state, a bolus of 0.5 mg/kg e noximone was administered, followed by an infusion of 0.5 mu g/kg/min. Besides the common haemodynamic parameters particulary the right-vent ricular ejection fraction (RVEF) was measured using a special thermodi lution technique. The predefined time points were: before administrati on of enoximone (baseline) and 5 min, 10 min, 15 min, 20 min, and 30 m in after bolus injection of enoximone. Compared to the baseline the ma ximum effects of enoximone were a 28% increase of cardiac index accomp anied by a 39% decline of systemic vascular resistance and an unchange d left-ventricular stroke-work index. While central venous pressure an d mean pulmonary artery pressure remained unchanged, RVEF (+20%) and r ight-ventricular stroke-work index (+30%) were significantly augmented , indicating improved right-ventricular performance. No adverse effect s of the enoximone administration were observed perioperatively. We co nclude that an enoximone monotherapy is beneficial for patients with i mpaired myocardial function undergoing cardiac surgery.