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[Indications and limits in the use of digitalis in chronic cor pulmonale (author's transl)]
Insights
Large doses of acetil-digoxin can transiently increase pulmonary pressure in patients with chronic obstructive lung disease (COLD). Cautious digitalization and improved ventilation are crucial for effective cardiac treatment in these patients.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Pharmacology
Context:
- Chronic obstructive lung disease (COLD) significantly impacts cardiovascular function, particularly the right ventricle.
- Assessing hemodynamic responses to cardiotonic drugs is vital for managing COLD patients.
Purpose:
- To evaluate the hemodynamic effects of acute intravenous acetil-digoxin in patients with COLD.
- To determine the impact of acetil-digoxin on right ventricular contractility indices and pulmonary artery pressure.
Summary:
- Intravenous acetil-digoxin administration in COLD patients caused a transient increase in pulmonary artery pressure (PAP) and pulmonary arteriolar resistance (RAP).
- This effect was more pronounced in patients with predominant emphysema (Group A) compared to bronchitis (Group B).
- Right ventricular contractility indices showed variable responses.
Impact:
- Digitalization in COLD patients requires a slow, cautious approach, especially in those with emphysema.
- Optimizing ventilation before initiating cardiotonic treatment is essential for a favorable cardiac response.
- Findings suggest careful consideration of acetil-digoxin dosage and timing in COLD management.
Abstract:
The analysis of the haemodymanic responses and the behaviour of many "contractility indices" of the right ventricle -- after acute intravenous injection of large doses of acetil-digoxin, in twelve patients with CPC caused by COLD with predominant clinical signs of emphysema (group A) or bronchitis (group B) -- showed an alarming, although transient, increase of the average pulmonary pressure (PAP), accompanied by rise of pulmonary arteriolar resistanced (RAP), especially in patients of the first group. In these cases a slow and cautious digitalization is required. It furthermore suggested that such treatment should start only after an efficient restoration of ventilation, in order to allow a good response of the heart to cardiocynetic treatment.