Effect of chronic oral digoxin therapy on ventricular function at rest and peak exercise in patients with ischemic heart disease.
Effect of chronic oral digoxin therapy on ventricular function at rest and peak exercise in patients with ischemic heart disease.
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长期口服地高辛治疗对缺血性心脏病患者静息和运动高峰时心室功能的影响。
DOI：
10.1016/0002-9149(80)90019-3
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发表时间：
1980
期刊：
影响因子：
--
通讯作者：
Willerson,JT
中科院分区：
文献类型：
--
作者：
Firth,BG;Dehmer,GJ;Corbett,JR;Lewis,SE;Parkey,RW;Willerson,JT
在14例已知患有缺血性心脏病的患者中，使用静息和仰卧运动时的多门控血池成像评估长期地高辛治疗对左心室射血分数、左心室容积和心输出量的影响。地高辛对静息或运动峰值时的射血分数无显著影响。运动和地高辛治疗对每搏输出量指数均无显著影响。心脏指数也没有显着影响地高辛无论是在休息（无地高辛时为3.1 ± 1.15，地高辛治疗期间为2.9 ± 1.03升/分钟/m2）或运动高峰时（分别为5.1 ± 2.08和5.1 ± 2.04升/分钟/平方米），尽管在每种状态下，心率的增加都导致了心脏指数的显著增加，地高辛治疗后静息时舒张末期和收缩末期容积指数均较治疗前有减小趋势，但差异无显著性。在8例静息时射血分数小于0.50（范围0.15 - 0.47）的患者中，无论是否使用地高辛治疗，舒张末期和收缩末期容积指数均随运动显著增加（p <0.05）。相反，在6名保存完好的患者中，（大于0.50）静息时射血分数，地高辛阻止运动诱导的舒张末期和收缩末期容积指数增加，在地高辛治疗期间，峰值运动收缩末期容积指数显著小于治疗前，（p <0.05）。结论是，稳定性缺血性心脏病患者的长期地高辛治疗（1）对未衰竭的心脏没有显著的有害功能作用，和（2）不会导致静息时左心室功能的显著变化，但（3）在静息时左心室功能保存良好的患者中，在峰值运动时确实提供了改善的心室功能。
The effect of chronic digoxin therapy on left ventricular ejection fraction, left ventricular volumes and cardiac output was assessed using multigated blood pool imaging both at rest and during supine exercise in 14 patients with known ischemic heart disease. Digoxin had no significant effect on ejection fraction at rest or at peak exercise. Neither exercise nor digoxin therapy had a significant influence on stroke volume index. Cardiac index was also not significantly influenced by digoxin either at rest (3.1 ± 1.15 without digoxin versus 2.9 ± 1.03liters/minper m2during digoxin therapy) or at peak exercise (5.1 ± 2.08 versus 5.1 ± 2.04liters/minper m2, respectively), although the increase in heart rate resulted in a significant increase in cardiac index with exercise in each state (p <0.01).End-diastolic and end-systolic volume indexes both tended to be smaller at rest after digoxin therapy than before, but this difference was not significant. In the eight patients with an ejection fraction at rest of less than 0.50 (range 0.15 to 0.47), both end-diastolic and end-systolic volume indexes increased significantly with exercise (p <0.05) irrespective of therapy with digoxin. Conversely, in the six patients with a well preserved (greater than 0.50) ejection fraction at rest, digoxin prevented the exerciseinduced increase in end-diastolic and end-systolic volume indexes, and at peak exercise end-systolic volume index was significantly smaller during digoxin therapy than before it (p <0.05).It is concluded that chronic digoxin therapy in patients with stable ischemic heart disease (1) does not have a significant deleterious functional effect on the nonfailing heart, and (2) does not result in a significant change in left ventricular function at rest, but that it (3) does provide improved ventricular function at peak exercise in patients with well preserved left ventricular function at rest.