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. 1970 Feb;49(2):358–364. doi: 10.1172/JCI106244

Experimental myocardial infarction

VI. Efficacy and toxicity of digitalis in acute and healing phase in intact conscious dogs

Raj Kumar 1,2,3,4, William B Hood Jr 1,2,3,4, Julio Joison 1,2,3,4, David P Gilmour 1,2,3,4, John C Norman 1,2,3,4, Walter H Abelmann 1,2,3,4
PMCID: PMC322477  PMID: 5411786

Abstract

Use of digitalis in myocardial infarction is controversial. To determine the efficacy and toxic threshold, serial infusions of 3 μg/kg per min of acetyl-strophanthidin were given to six intact conscious dogs 24 hr before and 1 hr, 2 days, and 7 days after myocardial infarction induced by inflation of a balloon cuff implanted on the left anterior descending coronary artery. Within 1 hr after myocardial infarction, heart rate increased by 28%. Left ventricular end-diastolic pressure increased from 7 to 20 mm Hg, and stroke volume decreased by 25%. At this time acetylstrophanthidin caused no beneficial hemodynamic change, 1 wk later, the heart rate and left ventricular end-diastolic pressure had declined toward normal but remained elevated. At this time, acetylstrophanthidin lowered left ventricular end-diastolic pressure by 25%, and increased the stroke volume and cardiac output by 25% and 21% respectively, without any change in heart rate or aortic pressure. Tolerance to acetylstrophanthidin, defined as appearance of ventricular tachycardia, declined the 1st hr after myocardial infarction by 24% (P<0.05) from the control level of 43 ±4 μg/kg (SEM), but subsequently returned to control.

Thus, immediately after myocardial infarction, tolerance to acetylstrophanthidin was reduced, and left ventricular failure was not ameliorated. 1 wk later in the healing phase of myocardial infarction, tolerance to acetylstrophanthidin returned to normal and left ventricular performance was improved by this drug. The study suggests a limited therapeutic role for digitalis in the treatment of left ventricular failure in the acute phase immediately after myocardial infarction, but beneficial effects may occur in the healing phase 1 wk later.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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