The use of digitalis for the treatment of congestive heart failure: A tale of its decline and resurrection
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Summary
The decline of the use of digitalis for the treatment of congestive heart failure was due to the introduction of oral diuretic therapy, the recognition of the frequency of digitalis induced arrhythmias and the uncontrolled observations that digitalis could frequently be withdrawn from patients with a history of heart failure without recurrence of heart failure. Subsequently, it has been well documented that digitalis has chronic beneficial hemodynamic effects in patients with chronic congestive heart failure. Moreover, digitalis has been shown to improve hemodynamics when added to other drugs including diuretics, ACE inhibitors and vasodilators. It is concluded that digitalis is a mild inotropic agent that is still a primary drug for the treatment of mild to moderate acute or chronic left ventricular failure.
Key Words
Digitalis congestive heart failure drug combination with digitalisPreview
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References
- 1.Wood P. The action of digitalis in heart failure with normal rhythm.Br Heart J 1940;2:132–140.Google Scholar
- 2.Beller GA, Smith TW, Abelmann WH et al. Digitalis intoxication: Prospective clinical study with serum level correlations.N Engl J Med. 1971;284:989–997.PubMedGoogle Scholar
- 3.Lown B, Marcus F, Levine HD. Digitalis and atrial tachycardia with block.N Engl J Med 1959;260:301–309.PubMedGoogle Scholar
- 4.Friedberg CK, Donoso E. Arrhythmias and conduction disturbances due to digitalis.Prog Cardiovasc Dis 1959;2:408–431.Google Scholar
- 5.Moss AJ, Davis HT, Conard DL, et al. Digitalis-associated cardiac mortality after myocardial infarction.Circulation 1981;64:1150–1156.PubMedGoogle Scholar
- 6.Bigger JT Jr, Fleiss JL, Rolnitzky LM, et al. Effect of digitalis treatment on survival after acute myocardial infarction.Am J Cardiol 1985;55:623–630.PubMedGoogle Scholar
- 7.The Digitalis Subcommittee of the Multicenter Post- Infarction Research Group. The mortality risk associated with digitalis treatment after myocardial infarction.Cardiovasc Drugs Ther 1987;1:125–132.Google Scholar
- 8.Gheorghiade M, Beller GA. Effects of discontinuing maintenance digoxin therapy in patients with ischemic heart disease and congestive heart failure in sinus rhythm.Am J Cardiol 1983;51:1243–1250.PubMedGoogle Scholar
- 9.The Consensus Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: Results of the Cooperative North Scandinavian Survival Study (CON-SENSUS).N Engl J Med 1987;316:1429–1435.Google Scholar
- 10.Cohn JN, Archibald DG, Ziesche S, et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure: Results of a Veterans Administration cooperative study.N Engl J Med 1986;314:1547–1552.PubMedGoogle Scholar
- 11.Braunwald E. Effects of digitalis on the normal and the failing heart.J Am Coll Cardiol 1985;5:51A-59A.PubMedGoogle Scholar
- 12.Gheorghiade M, St. Clair J, St. Clair C, Beller GA. Hemodynamic effects of intravenous digoxin in patients with severe heart failure initially treated with diuretics and vasodilators.J Am Coll Cardiol 1987;9:849–857.PubMedGoogle Scholar
- 13.Ribner HS, Plucinski DA, Hsieh AM, et al. Acute effects of digoxin on total systemic vascular resistance in congestive heart failure due to dilated cardiomyopathy: A hemodynamic-hormonal study.Am J Cardiol 1985;56:896–904.PubMedGoogle Scholar
- 14.Rackow EC, Packman MI, Weil MH. Hemodynamic effects of digoxin during acute cardiac failure: A comparison in patients with and without acute myocardial infarction.Crit Care Med 1987;15:1001–1005.PubMedGoogle Scholar
- 15.Marchionni N, Pini R, Vannucci A, et al. Hemodynamic effects of digoxin in acute myocardial infarction in man: A randomized controlled trial.Am Heart J 1985;109:63–68.PubMedGoogle Scholar
- 16.Ribner HS, Zucker MJ, Stasior C, et al. Vasodilators as first-line therapy for congestive heart failure: A comparative hemodynamic study of hydralazine, digoxin and their combination.Am Heart J 1987;114:91–96.PubMedGoogle Scholar
- 17.Gheorghiade M, Hall V, Lakier JB, Goldstein S. Comparative hemodynamic and neurohormonal effects of intravenous captopril and digoxin and their combinations in patients with severe heart failure.J Am Coll Cardiol 13:134 42, 1989.Google Scholar
- 18.Cantelli I, Pavesi PC, Parchi C, et al. Acute hemodynamic effects of combined therapy with digoxin and nifedipine in patients with chronic heart failure.Am Heart J 1983;106:308–315.PubMedGoogle Scholar
- 19.Raabe DS. Combined therapy with digoxin and nitroprusside in heart failure complicating acute myocardial infarction.Am J Cardiol 1979;43:990–994.PubMedGoogle Scholar
- 20.Cook LS, Lucas SK, Whitsett T, et al. Hemodynamic effects of combined digoxin and dopamine administration in postoperative patients with cardiac dysfunction.Am J Surg 1983;146:807–810.PubMedGoogle Scholar
- 21.Bostrom PA, Andersson J, Johansson BW, et al. Haemodynamic effects of prenaterol and cardiac glycosides in patients with recent myocardial infarction.Eur J Clin Invest 1984;14:175–180.PubMedGoogle Scholar
- 22.Mulrow CD, Feussner JR, Velez R. Reevaluation of digitalis efficacy. New light on an old leaf.Ann Intern Med 1984;101:113–117.PubMedGoogle Scholar
- 23.McHaffie D, Purcell H, Mitchell-Heggs P, Guz A. The clinical value of digoxin in patients with heart failure and sinus rhythm.Q J Med 47:401–419, 1978.PubMedGoogle Scholar
- 24.Lee DC, Johnson RA, Bingham JB, et al. Heart failure in outpatients. A randomized trial of digoxin versus placebo.N Engl J Med 1982;306:699–705.PubMedGoogle Scholar
- 25.Dobbs SM, Kenyon WI, Dobbs RJ. Maintenance digoxin after an episode of heart failure: Placebo-controlled trial in outpatients.Br Med J 1977;1:749–752.PubMedGoogle Scholar
- 26.Fleg JL, Gottlieb SH, Lakatta EG. Is digoxin really important in treatment of compensated heart failure?Am J Med 1982;73:244–250.PubMedGoogle Scholar
- 27.Dobbs RJ, Kenyon WI, Dobbs SM. Maintenance digoxin (letter to the editor).Br Med J 1977;1:1350.Google Scholar
- 28.Fleg JL, Rothfeld B, Wright J, et al. Does digoxin enhance exercise left ventricular function in patients with congestive heart failure?J Am Coll Cardiol 1987;9:132A.Google Scholar
- 29.Guyatt GH, Sullivan MJJ, Fallen EL, et al. A controlled trial of digoxin in congestive heart failure.Am J Cardiol 1988;61:371–375.PubMedGoogle Scholar
- 30.Arnold SB, Byrd RC, Meister W, et al. Long-term digitalis therapy improves left ventricular function in heart failure.N Engl J Med 1980;303:1443–1448.PubMedGoogle Scholar
- 31.Davies RF and the Canadian Enalapril vs. Digoxin Multicentre Study Group. Reduced exercise tolerance after digoxin withdrawal in class II–III heart failure.Circulation 1988;78(Suppl 2):53a.Google Scholar
- 32.The Captopril-Digoxin Multicenter Research Group. Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure.JAMA 1988;259:539–544.Google Scholar
- 33.The German and Austrian Xamoterol Study Group. Double-blind placebo-controlled comparison of digoxin and xamoterol in chronic heart failure.Lancet 1988;1:489–493.Google Scholar
- 34.DiBianco R, Shabetai R, Kostuk W, Moran J, Schlant R, Wright R and the Milrinone Multicenter Trial Group. Oral milrinone and digoxin in heart failure: Results of a placebo-controlled, prospective trial of each agent and the combination.Circulation 1987; 76 (Suppl 4):256a.Google Scholar
- 35.Haerer W, Bauer V, Hetzel M, Fehske KJ. Long-term effects of digoxin and diuretics in congestive heart failure—Results of a placebo-controlled randomized double blind study.Circulation 1988; 78 (Suppl 2):53.Google Scholar