Variability of hemodynamic responses to acute digitalization in chronic cardiac failure due to cardiomyopathy and coronary artery disease.

作者: Keith Cohn , Arthur Selzer , Edward S. Kersh , Leonard S. Karpman , Nora Goldschlager

DOI: 10.1016/0002-9149(75)90827-9

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摘要: Abstract Eight patients with chronic congestive heart failure (four cardiomyopathy and four ischemic disease) underwent hemodynamic studies during acute administration of digoxin, given intravenously in two 0.5 mg doses 2 hours apart. Observations were made before digitalis (control period) serially thereafter for 4 after the first dose. Resting mean cardiac index pulmonary arterial wedge pressure as follows: 2.0 liters/min per m 23 mm Hg period); 2.1 24 (at 1 hour); hours); 2.7 19 3 2.3 20 hours). Exercise responses five were: 3.1 36 3.2 33 28 27 3.4 31 The remained elevated exercise all cases. Arrhythmias seen digoxin. Hemodynamic improvement at involving both reduced filling increased blood flow was observed only rest one additional patient exercise. Acute deterioration function (elevated or decreased index) occurred 30 minutes digoxin patients, concomitantly systemic resistance. In six a peak effect appeared to 12 partial total loss initial benefit by hours. previously performed observations have seldom exceeded hour; results this hour study suggest that, coronary artery disease failure, digitalization does not necessarily lead consistent, marked lasting improvement. Thus, current concepts use such may require revision.

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