Oral treatment with enoximone in patients referred for cardiac transplantation

Abstract

A prospective, uncontrolled, open ended study was performed to assess the effect of treatment with oral enoximone therapy in patients with end stage cardiac failure unresponsive to conventional treatment. The primary objective of treatment, hospital discharge, was achieved in 27 of 35 patients studied. Baseline haemodynamics were obtained in 21 patients. The mean cardiac index of patients who improved by one or more grades (New York Heart Association) was 2.1 litres/min while, in those who had less improvement, the mean cardiac index was 1.5 l/min ( P < 0.01). The average duration of treatment was 13 weeks, treatment being discontinued in 25 patients within twelve weeks. The main reasons for discontinuation were side effects ( n = 11), and progressive cardiac failure ( n = 7). The prognosis of patients in whom therapy was discontinued was very poor, only 5 of 28 being discharged from hospital without cardiac transplantation. Sudden death was uncommon ( 1 13 ), and Holter monitoring in 17 showed no aggravation of ventricular arrhythmias. Oral treatment with enoximone is a useful adjunct in the treatment of end stage cardiac failure.