| Digitalis and heart failure: does digitalis really produce beneficial effects through a positive inotropic action? | |
| | |
MedLine Citation:
|
PMID: 1450089 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Although digitalis was introduced to medicine long ago, the drug is still extensively used in clinical practice today. Opinions on its mechanism of action have undergone much change in the course of time, and the way in which cardiovascular effects are produced is still not completely clear. Limitations and contraindications for the use of digitalis substances are reported, especially in the treatment of ischemic heart disease. Preliminary data regarding the effects of digitalis on the diastolic phase are unfavorable, although the relationship between digitalis and diastolic function ought to be studied in greater depth in various clinical conditions. In spite of many recent trials, the old question of the usefulness of digitalis in the chronic treatment of patients in sinus rhythm and heart failure is still debated. An important clinical benefit in the chronic use of digitalis appears restricted to a relatively small proportion of patients with severe congestive heart failure, while in the majority of chronically treated subjects the effects of the drug are scanty or insignificant. The beneficial effect of digitalis used chronically is essentially believed to be due to its positive inotropic action. Since the vagomimetic and the antiadrenergic effects of digitalis have been demonstrated to be independent from its inotropic action, they could be considered determinants of the clinical benefits of digitalis. These indirect effects may be useful in the control of the negative neuroendocrine response developing during congestive heart failure. Thus the statement that digitalis is essentially an inotropic agent seems restrictive; its definition should reflect the favorable effects obtained in some cases of congestive heart failure rather than its various and contrasting underlying mechanisms of action. |
| | |
Authors:
|
R Bolognesi; D Tsialtas; C Manca |
Related Documents
:
|
19474739 - Validity, prognostic value and optimal cutoff of respiratory muscle strength in patient... 2378249 - Decreased r-r variance in panic disorder patients. 21324139 - Centrilobular emphysema combined with pulmonary fibrosis results in improved survival. 6832179 - Salivary electrolytes and digitalis. 2689729 - Enzyme immunoassay (elisa) for the detection of anticarbohydrate antibodies in rheumati... 2210899 - Enalapril as initial and sole treatment in severe chronic heart failure with sodium ret... 22677809 - High glycated hemoglobin levels and intracranial artery stenosis are predictive factors... 16154679 - Reducing no flow times during automated external defibrillation. 15605049 - Functional evaluation of intraarticular severely comminuted fractures of the calcaneus ... |
Publication Detail:
|
Type: Historical Article; Journal Article; Review |
Journal Detail:
|
Title: Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy Volume: 6 ISSN: 0920-3206 ISO Abbreviation: Cardiovasc Drugs Ther Publication Date: 1992 Oct |
Date Detail:
|
Created Date: 1993-01-07 Completed Date: 1993-01-07 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8712220 Medline TA: Cardiovasc Drugs Ther Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 459-64 Citation Subset: IM; Q |
Affiliation:
|
Cattedra di Cardiologia, Università degli Studi di Parma, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Digitalis* Digitalis Glycosides / contraindications, therapeutic use* Heart Failure / drug therapy* History, 18th Century History, 19th Century History, 20th Century Humans Myocardial Contraction / drug effects* Plants, Medicinal* Plants, Toxic* |
| Chemical | |
Reg. No./Substance:
|
0/Digitalis Glycosides |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Autologous bone marrow transplantation for Hodgkin's disease.
Next Document: A comparison of the effects of captopril and flosequinan in patients with severe heart failure.