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Hemodynamic and plasma atrial natriuretic peptide responses to acute digitalis therapy in patients with normal and

Wayne L Miller1, Kent R Bailey, Susan A Weston

  • 1Division of Cardiovascular Diseases, Department of Biostatistics, Mayo Clinic and Mayo Foundation, 200 First Street, SW, Rochester, MN 55905, USA. miller.wayne@mayo.edu

European Journal of Heart Failure
|January 29, 2002
PubMed

Insights

Digitalis improves heart function in patients with left ventricular dysfunction (LVD) by enhancing hemodynamics. This effect may be linked to digitalis-stimulated release of atrial natriuretic peptide (ANP) during stress.

Area of Science:

  • Cardiology
  • Pharmacology
  • Physiology

Background:

  • Digitalis has a historical role in heart failure treatment.
  • Its precise effects on cardiac hemodynamics and neurohormonal modulation remain unclear.

Purpose of the Study:

  • To investigate the relationship between atrial natriuretic peptide (ANP) and hemodynamic responses to digitalis.
  • To assess these effects in patients with normal and impaired left ventricular function (LVD).

Main Methods:

  • Thirty patients (20 with LVD, 10 controls) were studied.
  • Hemodynamics and plasma ANP were measured supine and with leg elevation, before and after digitalis administration.

Main Results:

  • Digitalis improved hemodynamics in LVD patients, reducing heart rate, filling pressures, and mean pulmonary artery pressure while increasing cardiac index.
  • These improvements were maintained during leg elevation stress.
  • Leg elevation post-digitalis increased ANP levels despite reduced filling pressures.

Conclusions:

  • Acute digitalis administration improves cardiac hemodynamics in LVD patients.
  • This improvement may involve digitalis-induced release of myocardial ANP under hemodynamic stress.
Abstract

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