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Biomedical subjects

M C Jain

Publications and source records attributed to M C Jain.

25 records · Page 2Linked to original sources
PubMed1986

Enoximone (MDL 17,043) for stable, chronic heart failure secondary to ischemic or idiopathic cardiomyopathy.

To examine the efficacy and safety of enoximone for treatment of patients with chronic, clinically stable cardiac failure secondary to ischemic or myopathic heart disease, 31 patients were enrolled into an early phase II trial. The hemodynamic response to intravenous and oral enoximone was assessed and compared with the response to dobutamine therapy (5 to 10 micrograms/kg/min). Maximal O2 uptake, an objective measure of effort tolerance, was serially monitored. Intravenous (1 to 2 mg/kg) and oral (1 to 2 mg/kg) enoximone improved (p less than 0.05) cardiac index while reducing right atrial and wedge pressures to a greater extent than dobutamine. The salutary hemodynamic response to oral enoximone was sustained for 6 to 8 hours and was not associated with subacute drug tolerance. Maximal O2 uptake was increased (p less than 0.05) at 2, 4, 8, 12, 24 and 52 weeks of oral enoximone therapy (1.4 +/- 0.5 mg/kg every 8 hours) while radionuclide ejection fraction at 65 weeks increased (p less than 0.05) from baseline (39 +/- 16% vs 30 +/- 9%). Nine patients, 8 of whom were in functional class III or IV on enrollment, died after a mean of 18 weeks: 4 from cardiac failure and 5 suddenly. Two patients had adverse gastrointestinal effects. Oral enoximone (1 to 2 mg/kg every 8 hours) appears to be useful in the short- and long-term management of clinically stable, chronic cardiac failure. Controlled phase III trials are warranted.

Administration, Oral↗
PubMed1985

False localization of site of endocarditis by cardiac catheterization with quantitative cultures.

The authors present a patient with relapsing Pseudomonas aeruginosa endocarditis in whom cardiac catheterization with quantitative cultures falsely localized the infection to the tricuspid valve, probably because the patient was having intermittent rather than continuous bacteremia. After catheterization the patient developed mitral insufficiency and congestive heart failure. This experience suggests that quantitative cultures during cardiac catheterization may give misleading results and that the procedure may have significant complications.

Adult↗
PubMedDate not supplied

Enoximone (MDL 17,043), a phosphodiesterase inhibitor, in the treatment of advanced, unstable chronic heart failure.

Patients with advanced heart failure may be candidates for mechanical circulatory support, heart transplantation, or both. Optimal medical therapy in such patients, who are frequently unstable clinically, is focused on traditional and newer methods of inotropic support. Accordingly, the response to intravenous and oral enoximone, an experimental compound with phosphodiesterase inhibitory properties, was examined in 25 patients with unstable, severe chronic heart failure as a result of ischemic or myopathic heart disease. Eight hospitalized patients had far-advanced failure and were dependent on dobutamine, dopamine, or both to support their cardiocirculatory status (group 1). Seventeen patients had severe failure and were hospitalized electively because of their clinical instability despite digoxin, diuretics, and vasodilators (group 2). Intravenous (1 to 2 mg/kg) and oral (1 to 2 mg/kg) enoximone significantly (p less than 0.05) improved right and left heart function, and the salutory hemodynamic response was sustained for 6 to 8 hours. In group 1, catecholamines were discontinued and clinical stability was reestablished on oral enoximone; stability was also restored in group 2. Nevertheless, 19 patients died on long-term enoximone therapy with approximately half succumbing to their heart failure. Thus enoximone, a compound with inotropic and vasodilator properties, was useful in the acute and short-term management of unstable, chronic heart failure and had an additive hemodynamic benefit to dobutamine, dopamine, or both. Enoximone may therefore be a useful adjunct to stabilizing these patients before mechanical circulatory support or transplantation. The advanced degree of myocardial failure in these patients, however, precludes enoximone together with standard medical therapy from having a more favorable impact on clinical outcome in these patients.

Administration, Oral↗