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Evaluation of digitalis in cardiac failure
British Medical Journal (Clinical Research Ed.)
|May 22, 1982
Summary
Digitalis glycosides like ouabain and digoxin showed modest benefits for heart failure patients in sinus rhythm. Hemodynamic improvements were observed only during exercise, not at rest.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Symptomatic cardiac failure in sinus rhythm presents significant challenges.
- Digitalis glycosides are commonly used for heart failure management.
Purpose of the Study:
- To investigate the hemodynamic effects of intravenous ouabain and oral digoxin in patients with cardiac failure.
- To assess the impact of digitalis on left ventricular ejection fraction at rest and during exercise.
Main Methods:
- Ten patients in sinus rhythm with symptomatic cardiac failure were studied.
- Hemodynamic profiles and left ventricular ejection fraction were measured before and after ouabain and digoxin treatment.
- Measurements were taken at rest and during dynamic exercise.
Main Results:
- No significant changes in hemodynamics or ejection fraction were observed at rest.
- During exercise, ouabain and digoxin significantly reduced left ventricular filling pressure.
- Cardiac index, stroke volume index, and stroke work index improved significantly during exercise.
- Left ventricular ejection fraction increased during exercise after both glycosides.
Conclusions:
- Intravenous ouabain and oral digoxin exert a modest positive inotropic effect in heart failure patients with sinus rhythm.
- The hemodynamic benefits of digitalis in these patients are primarily evident during physical exertion.