[Role of digitalis derivatives in the treatment of cardiac insufficiency with sinusal rhythm].
The value of digitalis in the treatment of heart failure with sinus rhythm remains controversial. It has been demonstrated that the moderate positively inotropic effect of digitalis observed after acute administration persists without tachyphylaxis. Digitalis produces symptomatic improvement, but its therapeutic quotient is low and its influence on mortality is unknown. This last point has become crucial, especially since some positively inotropic drugs increase ventricular rhythm disorders and are responsible for over-mortality among heart failure patients. In contrast, angiotensin-converting enzyme inhibitors reduce mortality in patients with severe heart failure. In short, digitalis is useful only in certain physiopathological types of heart failure where it is used electively and complements the action of angiotensin-converting enzyme inhibitors.
Aumont
M C
MC
Service de Cardiologie, Hôpital Bichat, Paris.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004071:Digitalis Glycosides / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006337:Heart Murmurs; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D015337:Multicenter Studies as Topic; D009200:Myocardial Contraction / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic
D000806:Angiotensin-Converting Enzyme Inhibitors; D004071:Digitalis Glycosides
Place des digitaliques dans le traitement de l'insuffisance cardiaque en rythme sinusal.