PMID- 8427136
OWN - NLM
STAT- MEDLINE
DCOM- 19930304
LR  - 20190626
IS  - 0002-8703 (Print)
IS  - 0002-8703 (Linking)
VI  - 125
IP  - 2 Pt 1
DP  - 1993 Feb
TI  - Long-term outcome of enoximone therapy in patients with refractory heart failure.
PG  - 423-9
AB  - Few options are available for patients with severe heart failure that is 
      unresponsive to therapy with digoxin, diuretics, and vasodilators. The clinical 
      responses and predictors of survival were studied in 41 consecutive patients with 
      New York Heart Association (NYHA) class IV heart failure during long-term oral 
      enoximone therapy (mean dose 232 +/- 15 mg/day). The mean age was 60 +/- 1 years, 
      and the initial left ventricular ejection fraction was 0.19 +/- 0.01. The cause 
      of heart failure was either coronary artery disease (n = 23) or dilated 
      cardiomyopathy (n = 18). Symptomatic improvement occurred in the majority (83%) 
      of patients; 24% improved two or more NYHA classes. Although the 12-month 
      mortality rate for the entire group was high (54 +/- 8%), a subgroup of patients 
      with dilated cardiomyopathy achieved a sustained benefit with a decrease in 
      symptoms > 1 NYHA class, fewer hospitalizations, and a survival rate at 24 months 
      of 60%. Multivariate analysis identified the cause of heart failure, left 
      ventricular ejection fraction, and clinical improvement within 60 days of 
      enoximone therapy as predictors of a favorable long-term outcome. The presence of 
      coronary artery disease was most predictive of early mortality (p < 0.0002), with 
      only 5% of patients surviving > 18 months compared to 66% of those with dilated 
      cardiomyopathy. Median survival rates were 132 +/- 31 and 921 +/- 214 days (p < 
      0.001) for the coronary artery disease and dilated cardiomyopathy populations, 
      respectively. Oral enoximone can provide symptomatic improvement and a palliative 
      option for the majority of patients with refractory heart failure resulting from 
      cardiomyopathy.
FAU - Dec, G W
AU  - Dec GW
AD  - Cardiac Unit, Massachusetts General Hospital, Boston 02114.
FAU - Fifer, M A
AU  - Fifer MA
FAU - Herrmann, H C
AU  - Herrmann HC
FAU - Cocca-Spofford, D
AU  - Cocca-Spofford D
FAU - Semigran, M J
AU  - Semigran MJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - C7Z4ITI7L7 (Enoximone)
SB  - IM
MH  - Cardiomyopathy, Dilated/drug therapy
MH  - Cause of Death
MH  - Coronary Disease/complications
MH  - Enoximone/*therapeutic use
MH  - Female
MH  - Heart Failure/*drug therapy/etiology/mortality/physiopathology
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 1993/02/01 00:00
MHDA- 1993/02/01 00:01
CRDT- 1993/02/01 00:00
PHST- 1993/02/01 00:00 [pubmed]
PHST- 1993/02/01 00:01 [medline]
PHST- 1993/02/01 00:00 [entrez]
AID - 0002-8703(93)90021-Z [pii]
AID - 10.1016/0002-8703(93)90021-z [doi]
PST - ppublish
SO  - Am Heart J. 1993 Feb;125(2 Pt 1):423-9. doi: 10.1016/0002-8703(93)90021-z.