Hemodynamic Effects of Digoxin on Congestive Heart Failure in Old Myocardial Infarction, Dilated Cardiomyopathy, Acute Myocardial Infarction and Mitral Stenosis

• Published in: Japanese Heart Journal Vol. 26; no. 2; pp. 155 - 164
• Main Authors: KUROGANE, Keiji, FUJITANI, Kazuhiro, FUKUZAKI, Hisashi
• Format: Journal Article
• Language: English
• Published: Tokyo International Heart Journal Association 01.01.1985; Japanese Heart Journal Association
• Subjects: Adult; Aged; Biological and medical sciences; Cardiomyopathy, Dilated - complications; Cardiomyopathy, Dilated - physiopathology; Cardiotonic agents; Cardiovascular system; Congestive heart failure; Digoxin; Digoxin - pharmacology; Female; Heart Failure - etiology; Heart Failure - physiopathology; Heart Rate - drug effects; Hemodynamics; Hemodynamics - drug effects; Humans; Male; Medical sciences; Middle Aged; Mitral Valve Stenosis - complications; Mitral Valve Stenosis - physiopathology; Myocardial Contraction - drug effects; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Pharmacology. Drug treatments; Pulmonary Wedge Pressure - drug effects; Human; Heart failure; Cardiotonic agent; Mitral valve; Infarct; Digitalis; Stenosis; Cardiovascular disease; Coronary heart disease; Chemotherapy; Heart disease; Hypertrophic cardiomyopathy; Myocardium; Hemodynamics
• ISSN: 0021-4868; 1348-673X
• DOI: 10.1536/ihj.26.155

The hemodynamic effects of digoxin (0.01mg/Kg) on congestive heart failure were compared in 32 patients with old myocardial infarction (OMI) (n=9), dilated cardiomyopathy (DCM) (n=10), acute myocardial infarction (AMI) (n=5) and mitral stenosis (MS) (n=8). The responses of heart rate (HR) and pulmonary capillary pressure (PCP) to digoxin in OMI, DCM and MS were marked but different in each of these groups and no significant changes were found in patients with AMI. The responses of cardiac index (CI) to digoxin in patients with OMI and DCM in whom left ventricular myocardial contractile force was impaired were divided into 2 groups (Group 1: CI increased more than 15% and Group 2: less than 15%). In Group 1, both CI and percent fractional shortening (%FS) before digoxin administration were lower than in Group 2, i.e., 1.97±0.27 vs 2.80±0.48L/min/m2 (p<0.001) and 10.9±8.0 vs 19.5±11.9% (p<0.05), respectively. In MS, CI increased after digoxin administration only in the 2 patients with low CI and rapid HR in the control state. These results indicate that the mode of hemodynamic response to digoxin is considerably different in various diseases. They further suggest that digoxin should not be used in the early phase of AMT, although digoxin was of great clinical benefit in patients with OMI and DCM through such mechanisms as its positive inotropic and negative chronotropic effects and lowering of PCP.