[Digoxin-induced constriction of epicardial coronary vessels in patients with coronary heart disease: reversibility by nitrates].
Heart diseases requiring glycoside therapy are often associated with coronary artery disease. This study evaluated quantitatively the effect of an intravenous bolus injection of digoxin (0.8 mg) on diameters of epicardial coronary arteries in 11 patients with coronary artery disease. Coronary angiograms were taken up to 30 min following intravenous administration of glycosides. The maximum decrease in mean diameters of angiographically normal coronary segments was 10.0 +/- 3.5% (p < or = 0.001) compared to control. Maximum reduction in minimal diameters of stenotic segments was 22.1 +/- 13.1% (p < or = 0.001). This vasoconstriction could be reversed with nitroglycerin. Thus, intravenous administration of digoxin induces vasoconstriction of normal and stenotic coronary arteries, which could cause ischemic complications in the presence of high-grade stenoses. Since digoxin-induced vasoconstriction could be reversed with nitroglycerin, concomitant vasodilator therapy is recommended.
Nolte
C W
CW
Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden.
Jost
S
S
Mügge
A
A
Daniel
W G
WG
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects* / Q000502:physiology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D004077:Digoxin / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000627:therapeutic use*; D012008:Recurrence
D004077:Digoxin; D005996:Nitroglycerin
Digoxin-induzierte Konstriktion epikardialer Koronargefässe bei Patienten mit koronarer Herzkrankheit: Reversibilität durch Nitrate.