| Effect of enoximone alone and in combination with metoprolol on myocardial function and energetics in severe congestive heart failure: improvement in hemodynamic and metabolic profile. | |
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MedLine Citation:
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PMID: 8364004 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The hemodynamic and myocardial metabolic effects of enoximone (phosphodiesterase III inhibitor), alone or in combination with metoprolol (beta-adrenergic blocker), were studied in patients with congestive heart failure. Ten patients (New York Heart Association Class III-IV) underwent right heart and coronary sinus catheterization, and parameters were assessed at basal condition, at peak enoximone response (mean intravenous loading dose = 2.2 mg/kg), and after the combination with metoprolol (mean intravenous dose = 8.5 mg). Heart rate tended to increase during enoximone administration (from 102 +/- 16 to 107 +/- 16 min-1, ns) and was reduced during enoximone plus metoprolol (to 88 +/- 15 min-1, p < 0.05 vs. basal). Cardiac index was increased during enoximone (from 2.2 +/- 0.2 to 3.8 +/- 0.5 1/min/m2, p < 0.05) and decreased during enoximone plus metoprolol (to 2.8 +/- 0.5 1/min/m2, p < 0.05 vs. enoximone). Mean pulmonary wedge pressure fell during enoximone and remained reduced during enoximone plus metoprolol (from 27 +/- 9 to 9 +/- 3 and to 13 +/- 4 mmHg, respectively, both p < 0.05). Myocardial oxygen consumption did not change during enoximone (from 27 +/- 8 to 25 +/- 13 ml/min, ns) and was reduced during enoximone plus metoprolol (to 19 +/- 8 ml/min, p < 0.05 vs. basal). Myocardial lactate extraction tended to be lower during enoximone and during enoximone plus metoprolol conditions (from 38 +/- 17% to 26 +/- 20% and to 29 +/- 24%, respectively), but no statistical significance was found. Myocardial efficiency was increased during enoximone and during enoximone plus metoprolol (from 9 +/- 3% to 15 +/- 6% and to 14 +/- 6%, respectively, both p < 0.05). Thus in patients with congestive heart failure enoximone improves hemodynamics and, in most cases, it does not influence energetics. The addition of metoprolol to enoximone reduces heart rate, cardiac index, and myocardial oxygen consumption without any other major changes, producing a more physiologic hemodynamic and metabolic profile. |
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Authors:
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N Galie; A Branzi; G Magnani; G Melandri; I Caldarera; C Rapezzi; C Grattoni; B Magnani |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy Volume: 7 ISSN: 0920-3206 ISO Abbreviation: Cardiovasc Drugs Ther Publication Date: 1993 Jun |
Date Detail:
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Created Date: 1993-10-04 Completed Date: 1993-10-04 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8712220 Medline TA: Cardiovasc Drugs Ther Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 337-47 Citation Subset: IM |
Affiliation:
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Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi di Bologna, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure / drug effects Cardiac Output / drug effects Coronary Circulation / drug effects Drug Synergism Drug Therapy, Combination Enoximone / pharmacology, therapeutic use* Female Heart Failure / drug therapy*, physiopathology Heart Rate / drug effects Hemodynamics / drug effects* Humans Lactates / metabolism Lactic Acid Male Metoprolol / pharmacology, therapeutic use* Middle Aged Myocardial Contraction / drug effects Myocardium / metabolism* Oxygen Consumption / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Lactates; 37350-58-6/Metoprolol; 50-21-5/Lactic Acid; 77671-31-9/Enoximone |
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