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Related Concept Videos

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...

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Related Experiment Video

Updated: Jul 20, 2026

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
10:05

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

Published on: July 7, 2016

Digoxin use in congestive heart failure. Current status

K Riaz1, A D Forker

  • 1Department of Internal Medicine, University Missouri-Kansas City, School of Medicine, USA.

Drugs
|June 9, 1998
PubMed
Summary

Digoxin helps manage mild heart failure by preventing clinical decline and hospitalizations, improving exercise capacity, and enhancing heart function, without impacting survival rates. This digitalis medication offers benefits even at lower doses.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • The efficacy of digitalis (digoxin) in treating congestive heart failure (CHF) with normal sinus rhythm remains a subject of ongoing debate.
  • Historical studies provided limited, often uncontrolled data, hindering definitive conclusions on digoxin's benefits and risks.

Purpose of the Study:

  • To critically evaluate the evidence for digoxin's use in heart failure, focusing on clinical outcomes, survival, and specific patient subgroups.
  • To assess the impact of digoxin on exercise tolerance, left ventricular function, and neurohormonal effects in heart failure patients.

Main Methods:

  • Review of historical uncontrolled studies (1969-1983) and higher-quality randomized, double-blind, placebo-controlled trials (1977-1991).
  • Analysis of major trials including the Prospective Randomised Study of Ventricular Failure and Efficacy of Digoxin (PROVED), Randomised Assessment of Digoxin on Inhibitors of the Angiotensin-Converting Enzyme (RADIANCE), and the Digitalis Investigation Group (DIG) trial.

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A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo
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A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo

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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Related Experiment Videos

Last Updated: Jul 20, 2026

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
10:05

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

Published on: July 7, 2016

A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo
05:14

A Doxorubicin-Induced Murine Model of Dilated Cardiomyopathy In Vivo

Published on: May 16, 2020

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

  • Inclusion of a DIG trial substudy examining digoxin's effect on survival in patients with preserved ejection fraction (diastolic dysfunction).

    • Main Results:

    • Digoxin was shown to prevent clinical deterioration and reduce hospitalizations in heart failure patients.
    • The drug improves exercise tolerance and left ventricular function.
    • Crucially, digoxin demonstrated no adverse effect on survival rates, even in patients with ejection fraction > 45% (diastolic dysfunction).
    • Evidence suggests a potential neurohormonal effect of digoxin, possibly at doses lower than 0.25 mg, particularly benefiting patients with mild heart failure.

    Conclusions:

    • Digoxin is the first inotropic agent demonstrated to improve heart failure outcomes without negatively impacting survival.
    • The drug is beneficial for patients with mild heart failure and diastolic dysfunction.
    • Further research into lower-dose digoxin and its neurohormonal mechanisms is warranted.