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[Digoxin therapy of chronic cardiac failure under control of its concentration in the blood]
Insights
Blood digoxin levels do not directly correlate with therapeutic effectiveness in heart failure patients. Optimal digoxin effects persist in atrial fibrillation, but inotropic effects diminish with continuous use in sinus rhythm.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic circulatory insufficiency is a prevalent condition.
- Cardiac glycosides, like digoxin, are commonly used for treatment.
- Understanding digoxin's efficacy and optimal dosing is crucial.
Purpose of the Study:
- To investigate the relationship between blood digoxin concentration and therapeutic effect.
- To compare digoxin's influence in patients with cardiac fibrillation versus sinus rhythm.
- To assess the duration of therapeutic effect and potential loss of efficacy.
Main Methods:
- Studied 59 patients with chronic circulatory insufficiency and cardiac fibrillation.
- Studied 89 patients with chronic circulatory insufficiency and sinus cardiac rhythm.
- Monitored blood digoxin concentrations and therapeutic responses during saturation and maintenance phases.
Main Results:
- Blood digoxin concentration changes followed similar patterns in both patient groups.
- The concentration of digoxin in the blood did not determine the potency of its therapeutic effect.
- Optimal therapeutic effects persisted in patients with cardiac fibrillation.
- Continuously used cardiac glycosides lost their inotropic effect in patients with sinus rhythm.
Conclusions:
- Digoxin's therapeutic efficacy is not solely determined by its blood concentration.
- Digoxin remains effective for prolonged periods in patients with cardiac fibrillation.
- Long-term use of cardiac glycosides may lead to diminished inotropic effects in sinus rhythm patients.
Abstract:
The influence of digoxin concentration in blood on its therapeutic effect was studied in 59 patients with chronic circulatory insufficiency and cardiac fibrillation and in 89 patients with chronic circulatory insufficiency and sinus cardiac rhythm. The changes in blood digoxin concentration in patients with cardiac insufficiency complicated by cardiac fibrillation with maintained sinus cardiac rhythm both during the "saturation" period and during maintenance treatment were of the same type. The content of digoxin in the blood does not determine the potency of its therapeutic effect. The optimum therapeutic effect of digoxin in all patients with cardiac fibrillation and signs of cardiac insufficiency persists for quite a long period of time. Continuously used cardiac glycosides lose their inotropic effect in patients with sinus cardiac rhythm.