[Recent myocardial infarction: role of digitalis therapy in patients with left ventricular dysfunction during exercise who participated in a short-term physical training program].

In order to verify the usefulness of long-term digitalis therapy during physical rehabilitation in patients with recent myocardial infarction (MI) and left ventricular disfunction during exercise, 24 consecutive pts with PAedP greater than or equal to 25 mmHg (Swan-Ganz cath.) at maximal work load were selected. Pts with angina, ST depression (greater than or equal to 2 mm), complex ventricular arrhythmias (Lown 4-5), symptoms of left ventricular failure were excluded. At random 12 pts were assigned to group A (digoxin therapy) and 12 to group B (no therapy). Serum digoxin level was on average 1.48 ng/ml (range 1-2.85 ng/ml). Both groups performed over 4 weeks the same controlled training program. Before and soon after the end of the training period all pts underwent to an exercise test, standard chest x-ray films, 24 hour ambulatory ECG and two-dimensional echocardiography. No complication was observed during exercise test and training period. Age, myocardial infarction location, cardiac volume and hemodynamic behaviour during the first exercise test were similar in both groups. After training, maximal work capacity was increased in group A by 14% and in group B by 16% without significant changes in PAedP and Cl; at the same work load PAedP was lower in group B (-12%, p less than .02) while LVSWI was increased in both groups (14% and 17% respectively, p less than .05). No significant changes in cardiac volume, left ventricular asynergy, EF, and ventricular premature beats were observed. QT interval at rest decreased significantly only in group A 408 +/- 31 msec vs 371 +/- 34 msec (p less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)