Does digitalis work in chronic heart failure? The end of a 200-year-old controversy.
Controlled trials using modern methods of assessment in well-defined groups of patients have now convincingly demonstrated that digitalis is an effective and well-tolerated drug in patients with chronic heart failure who have left ventricular systolic dysfunction. These encouraging findings concerning digitalis, however, should not be construed to suggest that the drug should be used alone in the treatment of heart failure. Digitalis cannot adequately control the fluid retention seen in most patients with chronic heart failure; diuretics should be added to maintain sodium balance. Digitalis has not been shown to prolong life in chronic heart failure; converting-enzyme inhibitors should be added to reduce morbidity and mortality. All three drugs should be used together in the management of patients with this disorder.
Packer
M
M
Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York.
D002908:Chronic Disease; D004071:Digitalis Glycosides / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000266:history; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans
D004071:Digitalis Glycosides