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Can new inodilators displace digitalis in the therapy of congestive heart failure?

  • Focused Section on Digoxin
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Summary

New inodilators that possess both positive inotropic and vasodilator actions have many favorable effects in patients with congestive heart failure, even in those with refractory heart failure. These effects are expected to prevent myocardial injury, improve peripheral circulation, depress the excessive endogenous neurohumoral activation, and, finally, improve the quality of life, and increase lifespan. However, experience with new inodilators has only begun. Several questions remain to be answered before these drugs can be widely used with safety, including whether lifethreatening adverse effects appear, mortality rate is lessened, and drug tolerance occurs. The therapeutic level of the dose and the relation between the effectiveness of the drug and the degree of the severity of heart failure should also be established. Therefore, long-term, randomized, doubleblind, placebo-controlled clinical trials will be necessary before the new inodilators can take the place of digitalis and thus become the mainstay of the therapy of congestive heart failure.

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  1. Third Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan

    Toshiaki Kumada & Chuichi Kawai

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  1. Toshiaki Kumada
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Kumada, T., Kawai, C. Can new inodilators displace digitalis in the therapy of congestive heart failure?. Cardiovasc Drug Ther 2, 751–755 (1989). https://doi.org/10.1007/BF00133204

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