CLINICAL VALUE OF DIGOXIN IN PATIENTS WITH HEART-FAILURE AND SINUS RHYTHM

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  • 1 January 1978
    • journal article
    • research article
    • Vol. 47  (188) , 401-419
Abstract
Patients (6) in sinus rhythm with congestive heart failure due to either myocardial infarction or cardiomyopathy, were given oral furosemide to eliminate edema. Symptomatic relief occurred as body weight was reduced, and after a dry basal weight was achieved, progressive-load exercise testing was done to examine any benefit that derived from adding oral digoxin to the diuretic. Three pairs of sub-maximal exercise tests were done at intervals over 3 mo., and the responses of each patient when using digoxin and diuretics were compared with those when using diuretics alone. One patient did not complete this study, because more frequent premature beats and increased angina followed the withdrawal of digoxin. For the 5 patients who completed 3 pairs of tests, there was no significant change in symptoms, in workload achieved, or in heart rate, respiratory rate, ventilation and respiratory quotient, whether digoxin was added or removed. In these patients where salt and water retention was controlled with diuretics, digoxin did not improve the capacity for exercise, and it is suggested that for such patients with myocardial disease in sinus rhythm, treatment should begin with diuretics.