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Abstract:
To assess the efficacy and safety of acute therapy with intravenous enoximone in patients with severe congestive heart failure, 118 patients from 5 centers were treated with incremental doses following 2 schedules: to a maximum cumulative dose of 3.0 mg/kg (44 patients) and to a maximum cumulative dose of 10.5 mg/kg (74 patients). Both schedules produced significant increases in cardiac index (55% and 68%, p less than 0.01 for both) and decreases in pulmonary capillary wedge pressure (-29% and -42%, p less than 0.01 for both). Similar beneficial effects were observed in systemic vascular resistance (-33% and -44%) and right atrial pressure (-30% and -46%), which also were statistically significant (p less than 0.01). Heart rate increased modestly (6% and 13%) and mean systemic arterial pressure decreased (-5% and -14%). Some adverse effect occurred in 20% of the patients. Cardiovascular (10%) and central nervous system (6.7%) were the most frequent side effects. However, a direct relation to enoximone therapy could not be established in this uncontrolled open-label study of acutely ill patients. It is concluded that intravenous enoximone produces beneficial hemodynamic effects in patients with severe congestive heart failure with minimal changes in heart rate and blood pressure at cumulative doses less than 3 mg/kg.