de Micheli Serra Alfredo, Pastelín Hernández Gustavo
Departamento de Farmacología, Instituto Nacional de Cardiología «Ignacio Chávez», México, D.F., México.
Gac Med Mex. 2015 Sep-Oct;151(5):660-5.
Since the end of the XVIII century, digitalis glycosides were employed in heart failure. They were considered initially as diuretics and later as cardiotonic agents or as positive inotropics. At the present time there are varied groups of positive inotropic agents, which have a beneficial action on the failing human myocardium. For example, the beta adrenergics, the phosphodiesterase III inhibitors such as milrinone, or the sensibilizers of myocardial proteins to Ca++ such as levosimendan and omecamtiv mecarbil. However, following the opinion of distinguished cardiologists, in the case of heart failure associated to atrial fibrillation, digitalis cannot be substituted.
自18世纪末以来，洋地黄苷类药物就被用于治疗心力衰竭。它们最初被视为利尿剂，后来被视为强心剂或正性肌力药物。目前有多种正性肌力药物，它们对衰竭的人体心肌有有益作用。例如，β肾上腺素能药物、米力农等磷酸二酯酶III抑制剂，或左西孟旦和奥米卡替麦卡比等使心肌蛋白对钙离子敏感的药物。然而，根据杰出心脏病专家的观点，在伴有心房颤动的心力衰竭病例中，洋地黄不能被替代。
