[Effects of digitalis on the left ventricular filling phase in the normal and ischemic heart. Angiographic study in man].
The effects of digitalis on the left ventricular diastolic phase are very scant. In order to gain a better insight into this problem, we measured the hemodynamic effects of an intravenous injection of K-strophantidin (0.005 mg/kg in a bolus given within 5-10 min) during the diastolic phase in 9 normal male subjects and in 9 male patients with coronary artery disease (CAD), maintaining a normal overall ejection fraction despite of the presence of some hypokinetic segments. Administration of K-strophantidin decreased significantly in normal controls the left ventricular volumes at 1/3, 1/2, 2/3 of the diastolic phase, whereas it did not produce significant change in CAD patients. Digitalis decreased the first and increased the second filling peak of the volumetric variable dV/dt in the normal controls, but not in the CAD patients. In the latter group the 2 peaks before digitalis administration were similar. The effects of digitalis on the dV/dt measured during the second filling peak were significantly different in the 2 groups. The increments of pressure in middle and end diastole in CAD patients were significantly greater than those observed in normal controls. Results of the present study suggest that digitalis has a negative influence on the left ventricular filling phase both in normal and CAD subjects. In fact digitalis modifies in normals the pattern of the left ventricular filling phase whereas it induces an untoward increase in the middle and end diastolic pressure in CAD patients.
Bolognesi
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R
Reggiani
A
A
Piazza
A
A
Barilli
A L
AL
Manca
C
C
D000328:Adult; D000792:Angiography; D003327:Coronary Disease / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects*; D013328:Strophanthins / Q000494:pharmacology*
D013328:Strophanthins; C029082:strophanthin K
Effetti della digitale sul riempimento ventricolare sinistro nel cuore normale ed ischemico. Studio angiografico nell'uomo.