Multicenter Trial of Oral Enoximone in Patients with Moderate to Moderately Severe Congestive Heart failure - Enoximone Exercise


Enoximone vs. placebo for exercise tolerance in moderate CHF.


Enoximone in combination with digoxin and diuretics improves symptoms and exercise. tolerance in moderate to moderately severe heart failure.

Study Design

Study Design:

Patients Screened: Not given
Patients Enrolled: 102
NYHA Class: II=(36%), III=(64%)
Mean Follow Up: 1.5 months
Mean Patient Age: 62
Female: 28
Mean Ejection Fraction: 22%

Patient Populations:

Clinical heart failure
Ability to exercise
Digoxin and diuretic therapy (long-term)


Vasodilator therapy
Women of childbearing potential
Restrictive cardiomyopathy
Significant valvular disease
Myocardial infarction within 3 months
Symptomatic ventricular arrhythmias
Frequent angina
Evidence of severe pulmonary, hepatic, neurologic disease
Creatinine > 3.0mg/dl

Primary Endpoints:

Exercise duration
Symptoms (overall feeling of impairment, physicians global evaluation of impairment, daily activity scale, NYHA functional class)

Secondary Endpoints:

Severity of dyspnea/fatigue
Number of hospitalizations
Change in ejection fraction
Drop out rate/adverse events

Drug/Procedures Used:

Enoximone (mean dose 300 mg/day; could be titrated during study)
Echocardiography performed at 6 weeks
Antiarrhythmic agents permitted
Exercise testing (modified Naughton protocol)
Oxygen consumption in subset of patients

Concomitant Medications:

Permitted to take antiarrhythmics, anticoagulants, K+ supplements

Principal Findings:

Enoximone in combination with digoxin and diuretics does not improve exercise

Dropout rate significantly greater with Enoximone (46%) non-placebo (25%)

With intention-to-treat analysis, 10 deaths in Enoximone group and 3 in placebo (p < 0.05).


"The unexpectedly worse survival rate with Enoximone therapy raises concerns about a possible detrimental effect of Enoximone in the dose range given in this study." (From Abstract)


1. Circulation 1990;82:774-80. Final Results

Clinical Topics: Heart Failure and Cardiomyopathies, Noninvasive Imaging, Acute Heart Failure, Echocardiography/Ultrasound

Keywords: Oxygen Consumption, Digoxin, Survival Rate, Diuretics, Intention to Treat Analysis, Heart Failure, Echocardiography, Cardiotonic Agents, Enoximone

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