USE OF ENOXIMONE IN PATIENTS WITH ACUTE A ND SUBACUTE HEART-FAILURE -AN INTENSIVE-CARE UNIT REPORT

The phosphodiesterase inhibitor enoximone has both vasodilating and po sitive inotropic pharmacological properties. The balance between vasod ilation and positive inotropism may be different between the various t ypes of heart failure as well as the various stages of heart failure. Therefore, we investigated the effect of intravenous application of en oximone (1 mg/kg body weight) in a cohort of patients (n = 10) sufferi ng from acute or subacute heart failure mainly due to ischemia or hypo xia. All patients had high left ventricular filling pressure, low card iac output and were pretreated with intravenous dobutamine. Enoximone increased cardiac output from 3.2 +/- 1.2 to 5.5 +/- 2.2 l/min, increa sed heart rate from 94 +/- 20 to 100 +/- 18 beats/min, decreased syste mic peripheral resistance from 1770 +/- 861 to 931 +/- 340 dyn.sec.cm( -5) and decreased pulmonary wedge pressure from 24 +/- 5 to 20 +/- 6 m mHg, significantly. However, systolic aortic pressure, systolic pulmon ary pressure and right atrial pressure were not significantly altered. We conclude that in a selected group of patients enoximone - given in travenously and acutely in the intensive care unity - can induce benef icial effects on central hemodynamics without critical falls in perfus ion pressure.