Comparative effects on hemodynamics of enoximone (MDL 17,043), dobutamine and nitroprusside in severe congestive heart failure

Installé, Etienne; González, M.; Jacquemart, Jean Luc; Collard, Philippe; Roulette, Francois; Pourbaix, Suzanne; Trémouroux, J

doi:10.1016/0002-9149(87)90525-x

Cited by 26 publications

(12 citation statements)

References 21 publications

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“…This would confirm results obtained in pa tients with congestive cardiac failure [22,23], in whom therapeutic reductions in pre load and afterload resulting from the admin istration of enoximone were associated with only moderate reductions in systemic ar terial pressure. Conventional vasodilators, such as sodium nitroprusside, also lower both preload and afterload but are inappro priate in patients with low systemic arterial pressures.…”

Section: Discussionsupporting

confidence: 83%

Nitroprusside-Sparing Effects of Enoximone

Chaudhri¹,

Kenny²

1990

Cardiology

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Thirty patients who had undergone coronary artery bypass grafting and who required vasodilator therapy for control of arterial hypertension were allocated to receive either low-dose or high-dose enoximone or placebo infusions. A closed-loop arterial pressure control system was used to assess cardiovascular stability and the amount of sodium nitro-prusside required to maintain control. There were no significant differences between the three groups in the time spent at 10, 20 and 30 mm Hg below the target pressure or at 10 and 20 mm Hg above the target pressure. However, the low-dose enoximone group spent a statistically greater amount of time at 30 mm Hg above the target pressure. There were no significant differences in the amount of sodium nitroprusside required to maintain control, in the duration of sodium nitroprusside infusion or in the heart rate. In conclusion, enoximone was not associated with a clinically significant effect on systolic pressure.

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Section: Discussionsupporting

confidence: 83%

Nitroprusside-Sparing Effects of Enoximone

Chaudhri¹,

Kenny²

1990

Cardiology

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“…Several workers have reported that enoximone can precipitate ventricular and supraventricular arrhythmias in up to 20% of patients with CHF (15,(17)(18)(19)(20) and this may be dose related.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Response to Intravenous Enoximone

World

1991

J R Army Med Corps

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“…One of the favorable effects of these inodilators on heart failure is an increase in cardiac output. Increases in myocardial contractility and decreases in peripheral resistance contribute to this improvement [8,10,[18][19][20][21][22][23][24][25][26][27]. Augmentation of cardiac output could redistribute the blood flow to the peripheral vessels, where compensatory vasocontriction had occurred, and improve subjective symptoms, which are mainly due to dyspnea caused by low-output failure.…”

Section: Toshiaki Kumada Chuichi Kawaimentioning

confidence: 99%

“…Augmentation of cardiac output could redistribute the blood flow to the peripheral vessels, where compensatory vasocontriction had occurred, and improve subjective symptoms, which are mainly due to dyspnea caused by low-output failure. Second, at an appropriate dose, they can decrease preload (ventricular filling pressure and heart size) [21,25,26,28], without much change in heart rate [21,25,26]. The decrease in preload reduces pulmonary venous and pulmonary wedge pressures, resulting in improvement of pulmonary congestion.…”

Section: Toshiaki Kumada Chuichi Kawaimentioning

confidence: 99%

“…Thus, inodilators may decrease myocardial oxygen consumption and increase the efficiency of the heart [23,25,26,29], because the decrease in filling pressure (or ventricular pressure) and heart size (ventricular volume) reduce the ventricular wall tension, which is a major determinant of myocardial oxygen consumption. This sequence is of some clinical importance in the decision as to whether to use inodilators in patients with coronary artery disease.…”

Section: Toshiaki Kumada Chuichi Kawaimentioning

confidence: 99%

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Can new inodilators displace digitalis in the therapy of congestive heart failure?

Kumada

Kawai

1989

Cardiovasc Drug Ther

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New inodilators that possess both positive inotropic and vasodilator actions have many favorable effects in patients with congestive heart failure, even in those with refractory heart failure. These effects are expected to prevent myocardial injury, improve peripheral circulation, depress the excessive endogenous neurohumoral activation, and, finally, improve the quality of life, and increase lifespan. However, experience with new inodilators has only begun. Several questions remain to be answered before these drugs can be widely used with safety, including whether life-threatening adverse effects appear, mortality rate is lessened, and drug tolerance occurs. The therapeutic level of the dose and the relation between the effectiveness of the drug and the degree of the severity of heart failure should also be established. Therefore, long-term, randomized, double-blind, placebo-controlled clinical trials will be necessary before the new inodilators can take the place of digitalis and thus become the mainstay of the therapy of congestive heart failure.

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Comparative effects on hemodynamics of enoximone (MDL 17,043), dobutamine and nitroprusside in severe congestive heart failure

Cited by 26 publications

References 21 publications

Nitroprusside-Sparing Effects of Enoximone

Nitroprusside-Sparing Effects of Enoximone

Patterns of Response to Intravenous Enoximone

Can new inodilators displace digitalis in the therapy of congestive heart failure?

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