Myhre E S, Gundersen T, Dickstein K, Hole T, Kjekshus J, Rønnevik P, Smith P, Westheim A
Medisinsk avdeling, Regionsykehuset i Tromsø.
Tidsskr Nor Laegeforen. 1995 Jan 30;115(3):360-4.
Congestive left heart failure can be treated using three main strategies: change preload to optimize the Frank-Starling relationship, decrease after-load to reduce external work and increase cardiac contractility by inotropic stimulation. The third option is reviewed in this article, which discusses the pharmacological and clinical effects of different inotropic drugs as known in 1994. It is concluded that digitalis should be considered apart from other inotropic drugs. Even when in sinus rhythm, digitalis seems reasonable as an adjuvans to after-load reduction and diuretics. Chronic use of other inotropic drugs for congestive left heart failure is not recommended.
改变前负荷以优化Frank-Starling关系，降低后负荷以减少外部做功，并通过变力性刺激增强心肌收缩力。本文将探讨第三种选择，讨论1994年已知的不同变力性药物的药理和临床作用。结论是，洋地黄应与其他变力性药物区别对待。即使在窦性心律时，洋地黄作为减轻后负荷和利尿剂的辅助药物似乎也是合理的。不建议长期使用其他变力性药物治疗充血性左心衰竭。
