Laperche T, Cohen-Solal A, Caviezel B, Gourgon R
Service de Cardiologie, Hôpital Beaujon, Clichy.
Ann Cardiol Angeiol (Paris). 1994 Mar;43(3):139-42.
While no doubt has ever been cast on the usefulness of digitalis in cardiac failure with atrial fibrillation and a fast ventricular rate, they are periodically brought into question regarding chronic cardiac failure in sinus rhythm. While they have not been supplanted by new positive inotropic agents, they are in competition with converting enzyme inhibitors. Recent therapeutic trials have shown that digitalis preparations, alone or in association with converting enzyme inhibitors, have beneficial effects on symptoms and exercise duration in patients with symptomatic impaired left ventricular systolic function. While the effects of digitalis preparations on mortality remain unknown, a large North American study should soon provide an answer to this question.
虽然洋地黄在伴有心房颤动和快速心室率的心力衰竭中的作用从未受到质疑,但在窦性心律的慢性心力衰竭方面,它们却不时受到质疑。虽然它们尚未被新的正性肌力药物所取代,但它们与转换酶抑制剂存在竞争。最近的治疗试验表明,洋地黄制剂单独使用或与转换酶抑制剂联合使用,对有症状的左心室收缩功能受损患者的症状和运动持续时间有有益影响。虽然洋地黄制剂对死亡率的影响尚不清楚,但一项大型北美研究很快将为这个问题提供答案。