Key result
Digitalis therapy may be overprescribed in patients whose heart failure is not primarily due to impaired myocardial contractility, requiring increased selectivity in its administration.
Why the study?
What are the appropriate indications for digitalis therapy in patients with congestive heart failure?
What are the appropriate indications for digitalis therapy in patients with congestive heart failure?
This historical review highlights the need for careful patient selection when prescribing digitalis for heart failure, cautioning against its overprescription.
May support restricting digitalis to systolic HF; leaves open precise indications in contemporary phenotypes.
The indications for use of digitalis as an inotropic agent have been reexamined in the context of recent emphasis on the toxicity of digitalis and current knowledge regarding the mechanisms of clinical congestive heart failure in various disease states. Digitalis may be overprescribed in patients in whom (1) the signs and symptoms of congestive heart failure are not due primarily to an impairment of myocardial contractility, (2) administration of digitalis is not associated with notable improvement in cardiac function, or (3) increases in contractility could have a deleterious effect on myocardial metabolism. There must be increased selectivity in the administration of digitalis to patients with heart disease and more emphasis on pharmacologic manipulation of other factors that control cardiac performance. (JAMA229:1911-1914, 1974)
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Jay N. Cohn (1974) conducted a review in Congestive heart failure. Digitalis was evaluated. Digitalis therapy may be overprescribed in patients whose heart failure is not primarily due to impaired myocardial contractility, requiring increased selectivity in its administration.
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