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Combined use of ultra-short acting beta-blocker esmolol and intravenous phosphodiesterase 3 inhibitor enoximone.
- Source :
-
Expert opinion on pharmacotherapy [Expert Opin Pharmacother] 2007 Sep; Vol. 8 (13), pp. 2135-47. - Publication Year :
- 2007
-
Abstract
- In patients with impaired myocardial contractility associated with downregulation of the beta-receptors, compounds inhibiting phosphodiesterase (PDE) 3 may be useful to increase contractility. The PDE3 inhibitor enoximone has been shown to improve pump-function independent from the beta-receptor pathway. A simultaneous decrease in ventricular preload and afterload by vasodilation has led to the term 'inodilator'. Esmolol is the only available ultra-short acting intravenous beta-blocking agent. Due to its half-life of approximately 9 min, beta-blockade, and thus, heart rate, can easily be titrated. Esmolol appears to be a helpful tool to avoid myocardial ischemia (e.g., in the perioperative setting). As with all other beta-blockers, it has dose-dependent negative inotropic effects, and this limits its use in patients with severe heart failure showing low cardiac output. It seems reasonable that an intravenous combination of both approaches, enoximone-induced positive inotropy and esmolol-associated protection from myocardial ischemia, might offer advantages by producing beneficial hemodynamic effects and by compensating each other's limitations in a complementary way. In spite of some promising results, the place of a combination of enoximone and esmolol in the process of treating patients with (acute) heart failure showing low output is still not entirely clear, and needs further confirmation.
- Subjects :
- Animals
Cardiovascular Diseases drug therapy
Cardiovascular Diseases metabolism
Drug Therapy, Combination
Humans
Infusions, Intravenous
Time Factors
Adrenergic beta-Antagonists administration & dosage
Enoximone administration & dosage
Phosphodiesterase Inhibitors administration & dosage
Propanolamines administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1744-7666
- Volume :
- 8
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Expert opinion on pharmacotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 17714066
- Full Text :
- https://doi.org/10.1517/14656566.8.13.2135