Hemodynamic Response to Digitalization in Patients with Incipient Myocardial Dysfunction Due to Hypertensive Cardiovascular Disease

Abstract

In a previous study we demonstrated different hemodynamic responses to exercise in 91 patients with hypertensive cardiovascular disease (HCD) without clinical symptoms or signs of cardiac failure. While cardiac output (CO) remained within normal range at rest and during exercise, there was evidence of left ventricular dysfunction (LVD), indicated by elevated pulmonary artery wedge pressures (PAWP) during exercise in 48% of the subjects. In an attempt to assess whether this dysfunction (i. e., elevated PAWP) is a consequence of incipient cardiac muscle failure, the following investigation was performed: 28 patients with HCD and LVD underwent hemodynamic studies at rest and during supine exercise before and 30 min after administration of 0.6 mg beta methyl digoxin intravenously. Measurements were made during right heart catheterization with a balloon-tipped catheter including determinations of CO and PAWP. The hemodynamic changes after administration of digitalis did not demonstrate a consistent and uniform improvement of cardiac performance in all patients with HCD and LVD.