Kleiman J H, Alderman E L, Goldman R H, Ingels N B, Daughters G T, Stinson E B
Am J Cardiol. 1979 May;43(5):1001-8. doi: 10.1016/0002-9149(79)90367-9.
To study the effects of digoxin on regional left ventricular performance, continuous ventricular dynamics were assessed in nine patients with stable coronary disease. Computer-assisted analysis of the fluoroscopic motion of surgically implanted mid wall myocardial markers was used. The markers define six minor ventricular radii and outline the left ventricle. One and one-half hours after administration of 1 mg of intravenous digoxin, mean velocity of circumferential fiber shortening for all segments increased 19 percent, from 0.67 +/- 0.06 to 0.78 +/- 0.06 circumference/sec (P less than 0.01) and ejection fraction increased 4.5 percent, from 0.50 +/- 0.03 to 0.53 +/- 0.03 (P less than 0.05). Segmental velocity of circumferential fiber shortening, total segmental shortening and early segmental systolic shrtening increased in 83 percent to 91 percent of normal segments, depending on which index was used. Only 45 to 55 percent of initially abnormal segments benefited from digoxin. In general, segmental dyssynergy increased even when net ventricular function was enhanced. These results suggest that in pateints with chronic left ventricular contraction abnormalities due to coronary disease, deterioration of performance in abnormal regions after administration of digoxin may result from increased stress imposed by increased afterload and by improved segmental dynamics in more normal areas.
为研究地高辛对左心室局部功能的影响，对9例稳定型冠心病患者的心室动力学进行了连续评估。采用计算机辅助分析手术植入的心肌中层标记物的荧光透视运动。这些标记物确定了六个较小的心室半径并勾勒出左心室轮廓。静脉注射1毫克地高辛后1个半小时，所有节段的圆周纤维缩短平均速度增加了19%，从0.67±0.06周径/秒增至0.78±0.06周径/秒（P<0.01），射血分数增加了4.5%，从0.50±0.03增至0.53±0.03（P<0.05）。根据所使用的指标，圆周纤维缩短的节段速度、总节段缩短和节段早期收缩期缩短在83%至91%的正常节段中增加。只有45%至55%最初异常的节段从地高辛中获益。一般来说，即使心室整体功能增强，节段性运动失调仍会增加。这些结果表明，在因冠心病导致慢性左心室收缩异常的患者中，服用地高辛后异常区域功能恶化可能是由于后负荷增加以及较正常区域节段动力学改善所施加的应力增加所致。
