Morisco C, Cuocolo A, Romano M, Nappi A, Iaccarino G, Volpe M, Salvatore M, Trimarco B
Department of Internal Medicine, Federico II University, Naples, Italy.
Am J Cardiol. 1996 Mar 1;77(7):480-5. doi: 10.1016/s0002-9149(97)89341-1.
This was a double-blind, placebo-controlled, crossover study designed to determine the influence of digitalis treatment on left ventricular (LV) response to physical exercise in patients with congestive heart failure (CHF). In 10 patients with CHF (ejection fraction 29 +/- 2%), LV function was assessed during upright bicycle exercise using an ambulatory radionuclide detector for continuous noninvasive monitoring of cardiac function. Exercise was performed during control conditions and after a 3-week treatment with digoxin (0.25 mg/day orally) or placebo. Ten normal volunteers matched for sex and age constituted the control group. In normals, exercise ejection fraction and end-diastolic volume increased (both p <0.001), while end-systolic volume decreased progressively (p <0.001). In control conditions, patients with CHF had a sharp increase in heart rate during exercise, while ejection fraction did not change; both end-diastolic and end-systolic volumes increased significantly (both p <0.001) during exercise. During digoxin treatment, heart rate response to exercise recorded in patients with CHF was comparable to that recorded in normal subjects. In addition, a significant increase in ejection fraction during exercise was detected (P <0.001), and the increase in end-systolic volume was significantly smaller than that observed in control conditions (p <0.05). When patients received placebo, the responses of LV function to exercise were comparable to those observed in control conditions. These findings demonstrate that digitalis has a favorable influence on LV functional adaptation to exercise in CHF.
这是一项双盲、安慰剂对照的交叉研究，旨在确定洋地黄治疗对充血性心力衰竭（CHF）患者左心室（LV）对体育锻炼反应的影响。在10例CHF患者（射血分数29±2%）中，使用动态放射性核素探测器在直立自行车运动期间评估LV功能，以连续无创监测心脏功能。在对照条件下以及在接受地高辛（0.25mg/天口服）或安慰剂治疗3周后进行运动。10名年龄和性别匹配的正常志愿者构成对照组。在正常人中，运动射血分数和舒张末期容积增加（均p<0.001），而收缩末期容积逐渐减少（p<0.001）。在对照条件下，CHF患者运动期间心率急剧增加，而射血分数未改变；运动期间舒张末期和收缩末期容积均显著增加（均p<0.001）。在地高辛治疗期间，CHF患者记录的运动心率反应与正常受试者记录的相当。此外，检测到运动期间射血分数显著增加（P<0.001），且收缩末期容积的增加显著小于对照条件下观察到的增加（p<0.05）。当患者接受安慰剂时，LV功能对运动的反应与对照条件下观察到的相当。这些发现表明，洋地黄对CHF患者LV功能对运动的适应性有有利影响。
