Leier C V, Binkley P F, Starling R C, Huss-Randolph P
Division of Cardiology, Ohio State University College of Medicine, Columbus 43210.
Am Heart J. 1989 May;117(5):1092-8. doi: 10.1016/0002-8703(89)90867-3.
Twenty patients with moderately severe congestive heart failure were randomized to chronic enoximone (n = 10) or placebo (n = 10) therapy in a double-blind manner and serially evaluated over a 16-week-period. The purpose of the study was to determine if the addition of standard doses (1 and 2 mg/kg) of this new phosphodiesterase inhibitor to conventional therapy (digitalis and diuretics) would alter the clinical and laboratory course of this patient population. Except for a transient improvement in the quality of life score, none of the symptomatology indicators were significantly affected by enoximone. Similarly, maximal exercise capacity was not altered. Enoximone did elicit a statistically significant augmentation of echocardiographic, radionuclide angiographic, and systolic time interval parameters of left ventricular function. These enoximone-induced effects were accompanied by a significant increase (7% to 11%) in resting heart rate. Enoximone is capable of improving ventricular function when added to digitalis-diuretic therapy in moderately severe congestive heart failure. While individual patients may benefit from enoximone, the ability of standard doses of this agent to improve symptoms and exercise capacity over a 16-week period appears somewhat limited in a moderately severe heart failure population as a whole. Furthermore, a disparity between improvement in ventricular function parameters and changes in clinical status and exercise performance is apparent in this heart failure population.
20例中度严重充血性心力衰竭患者被双盲随机分为慢性依诺昔酮治疗组（n = 10）和安慰剂治疗组（n = 10），并在16周内进行连续评估。本研究的目的是确定在常规治疗（洋地黄和利尿剂）基础上加用标准剂量（1和2mg/kg）的这种新型磷酸二酯酶抑制剂是否会改变该患者群体的临床和实验室病程。除生活质量评分有短暂改善外，依诺昔酮对任何症状指标均无显著影响。同样，最大运动能力也未改变。依诺昔酮确实引起了左心室功能的超声心动图、放射性核素血管造影和收缩期时间间期参数的统计学显著增加。这些依诺昔酮诱导的效应伴随着静息心率显著增加（7%至11%）。在中度严重充血性心力衰竭患者中，当在洋地黄-利尿剂治疗基础上加用依诺昔酮时，它能够改善心室功能。虽然个别患者可能从依诺昔酮中获益，但在整个中度严重心力衰竭患者群体中，该药物标准剂量在16周内改善症状和运动能力的能力似乎有限。此外，在这个心力衰竭患者群体中，心室功能参数的改善与临床状态和运动表现的变化之间存在明显差异。
