SELZER A
Calif Med. 1963 Jan;98(1):1-6.
(a) rest, or reduction of overload; (b) diuretic therapy and sodium restriction, and (c) administration of digitalis. In a series of patients treatment with the aid of the first two methods was compared with the effect of adding digitalis to this regimen.Clinically, most patients can be brought back to a state of compensation without the use of digitalis. Hemodynamically, digitalis exerts a further favorable action by improving cardiac performance. The discrepancy between clinical and hemodynamic cardiac state is emphasized, for patients may have no clinical evidence of cardiac failure and yet show hemodynamic abnormalities characteristic of serious impairment of cardiac performance. Thus digitalis has been shown to exert a favorable effect in cardiac failure even if such an effect cannot be clinically assessed.
(a) 休息,或减轻负荷;(b) 利尿治疗和限制钠摄入,以及 (c) 使用洋地黄。在一系列患者中,将前两种方法的治疗效果与在此方案中加用洋地黄的效果进行了比较。临床上,大多数患者不使用洋地黄也可恢复到代偿状态。从血流动力学角度看,洋地黄通过改善心脏功能发挥进一步的有益作用。强调了临床心脏状态与血流动力学心脏状态之间的差异,因为患者可能没有心力衰竭的临床证据,但却表现出心脏功能严重受损的血流动力学异常特征。因此,已证明洋地黄在心力衰竭中发挥有益作用,即使这种作用无法通过临床评估。