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[低剂量洋地黄毒苷对慢性心力衰竭(II/III期)患者心室功能的影响]

[Ventricle function in low-dose digitoxin in patients with chronic heart failure (stage II/III)].

作者信息

Staiger J, Späth J, Dickhuth H H, Keul J

出版信息

Z Kardiol. 1983 Aug;72(8):448-55.

PMID:6684850
Abstract

Using one- and two-dimensional echocardiographic parameters, left ventricular function and dimensions were investigated in 11 patients with chronic heart failure (NYHA stages II-III) and in 10 normal subjects after administration of low-dose digitoxin (0.07 mg). Tests were performed before the begin of therapy, on the 3rd day following rapid saturation, and on the 15th day under maintenance therapy. There was no significant decrease either of heart volume as assessed by X-ray or of enddiastolic volume measured echocardiographically. However--predominantly in patients--a marked decrease in endsystolic diameter (p less than 0.01) and an increase in posterior wall motion amplitude (p less than 0.05) was observed resulting in increased stroke volume, shortening fraction (p less than 0.001). Early diastolic left ventricular filling speed also increased significantly in both groups (p less than 0.01). Changes in these parameters were more pronounced in patients than in normal subjects. In both groups the effects were achieved soon after rapid saturation, increasing slightly during the period of chronic administration of low-dose digitoxin. Parallel to the changes in echocardiographic parameters, a noticeable clinical improvement occurred among patients. No side effects were observed as serum digitoxin levels were in the therapeutic range. It may be concluded that low-dose digitoxin can be employed to increase cardiac contractility in patients with heart failure.

摘要

利用一维及二维超声心动图参数,对11例慢性心力衰竭患者(纽约心脏协会心功能II - III级)及10名正常受试者在给予低剂量洋地黄毒苷(0.07毫克)后进行左心室功能及大小的研究。在治疗开始前、快速饱和后的第3天以及维持治疗的第15天进行检测。通过X线评估的心脏容积或超声心动图测量的舒张末期容积均无显著降低。然而,主要在患者中观察到收缩末期直径显著减小(p < 0.01)和后壁运动幅度增加(p < 0.05),导致每搏输出量增加、缩短分数增加(p < 0.001)。两组的舒张早期左心室充盈速度也均显著增加(p < 0.01)。这些参数的变化在患者中比在正常受试者中更明显。在两组中,快速饱和后不久就出现了这些效应,在低剂量洋地黄毒苷长期给药期间略有增加。与超声心动图参数的变化平行,患者出现了明显的临床改善。由于血清洋地黄毒苷水平在治疗范围内,未观察到副作用。可以得出结论,低剂量洋地黄毒苷可用于增加心力衰竭患者的心脏收缩力。

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