[Hemodynamic effects of enoximone--comparative studies of heart surgery patients]

Treatment of depressed myocardial pump function during cardiac surgery is usually based on catecholamines. Development of selective phosphodiesterase (PDE)-III-inhibitors such as enoximone seems to be an interesting aspect in treating myocardial dysfunction in this situation. In patients undergoing aorto-coronary bypass grafting, who where unable to be weaned from cardiopulmonary bypass (CPB) without pharmacologic support, i.v. injection of enoximone (0.5 mg/kg) resulted in significant better hemodynamics than after infusion of dobutamine in comparable patients. The mechanisms for improvement in ventricular function induced by enoximone appear to be enhanced contractility, owing to its positive inotropic effects, and a decrease in ventricular outflow resistance, resulting from peripheral vasodilation. The positive hemodynamic effects in patients additionally treated with catecholamines (epinephrine) may be of particular interest in patients with beta-receptor down-regulation phenomenon.