Key result
Intravenous digitoxin induced an abrupt slight increase in peripheral resistance, followed by a gradual increase in inotropy and a rapid, stable decrease in AV nodal conduction velocity.
Why the study?
Does intravenous digitoxin alter haemodynamics and AV nodal conduction in patients with chronic coronary heart disease without clinical heart failure?
Does intravenous digitoxin alter haemodynamics and AV nodal conduction in patients with chronic coronary heart disease without clinical heart failure?
Intravenous digitoxin induces an abrupt increase in peripheral resistance and a rapid, stable decrease in AV nodal conduction, followed by a gradual increase in inotropy in patients with ischemic heart disease.
Answers are grounded in this paper and cite their sources.
Should not change practice in coronary disease without HF; leaves open clinical relevance of these acute effects.
The haemodynamic and electrophysiologic responses to rapid intravenous injection of digitoxin (0.6 mg over 5 min) were measured in 6 patients with chronic coronary heart disease without clinical heart failure. Two minutes after end of injection peripheral resistance increased and stroke volume fell, while peak dP/dt in the right ventricle showed minimal increase. AV nodal conduction velocity decreased markedly. Thereafter, the peripheral resistance remained unchanged, stroke volume and peak dP/dt in the right ventricle increased slightly, while AV conduction remained stable. In 2 control patients stable values were found during 60 min. We conclude that digitoxin given intravenously as a single bolus injection induces an abrupt slight increase in peripheral resistance. Thereafter, a gradual increase in inotropy is found. The effect on the AV node appears rapidly and remains stable.
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Amlie et al. (1984) studied chronic coronary heart disease without clinical heart failure (n=8). intravenous digitoxin vs. control patients was evaluated on haemodynamic and electrophysiologic responses. Intravenous digitoxin induced an abrupt slight increase in peripheral resistance, followed by a gradual increase in inotropy and a rapid, stable decrease in AV nodal conduction velocity.
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