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[Changes in left-ventricular function in chronic congestive heart failure treated with digoxin, furosemide and
K Markiewicz1, T Dryjański, M Cholewa
1I Kliniki Chorób Wewnetrznych Instytutu Medycyny Wewnetrznej WAM w Lodzi.
Kardiologia Polska
|February 1, 1990
Summary
This study found that captopril significantly improved left ventricular function in patients with congestive heart failure, outperforming nifedipine and isosorbide dinitrate when added to standard digoxin and furosemide therapy.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Congestive heart failure (CHF) significantly impairs left ventricular function.
- Standard therapy with digoxin and furosemide provides limited improvement for advanced CHF.
Purpose of the Study:
- To evaluate the efficacy of adding nifedipine or isosorbide dinitrate to digoxin and furosemide in CHF patients.
- To assess the impact of captopril on left ventricular function in CHF.
Main Methods:
- 48 patients with NYHA class III-IV CHF received standard therapy (digoxin, furosemide).
- Groups received either nifedipine or isosorbide dinitrate, followed by captopril, with echocardiography assessing left ventricular function at each stage.
- Drug dosages were optimized for daily administration.
Main Results:
- Nifedipine and isosorbide dinitrate did not improve left ventricular function compared to standard therapy.
- Captopril, when added to digoxin, furosemide, and nifedipine, significantly improved ejection fraction (p<0.001) and reduced ventricular diameters (p<0.05).
- Captopril demonstrated greater hemodynamic improvement than isosorbide dinitrate.
Conclusions:
- Captopril offers significant hemodynamic benefits in CHF patients when combined with digoxin, furosemide, and nifedipine.
- Neither nifedipine nor isosorbide dinitrate provided additional benefit over standard therapy alone.
- Captopril represents a valuable therapeutic option for improving cardiac function in advanced heart failure.