Cardiac and peripheral vascular effects of digitalis in clinical cardiogenic shock

Jay N. Cohn, Felix E. Tristani, Ibrahim M. Khatri

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

The hemodynamic effects of cardiac glycosides were studied in 13 patients with cardiogenic shock. Intravenous administration of ouabain, deslanoside, or digoxin produced a prompt pressor effect which was characterized by increases in systemic vascular resistance and tension time index and no change or increase in right atrial pressure (RAP) and left ventricular enddiastolic pressure (LVEDP). Acute pulmonary edema developed during this period in one patient. During the later phase, 15 to 60 minutes after infusion of digitalis, there were increases in the maximum rate of rise of left ventricular pressure (LV dp dt), mean systolic ejection rate, and left ventricular stroke work usually with a fall in RAP or LVEDP. Despite the evidence of improved myocardial function, cardiac output (CO) was not significantly increased and was always lower than that attained during infusion of isoproterenol. It is concluded that digitalis is not very effective by itself in restoring blood flow in cardiogenic shock and that the early peripheral vasoconstrictor effect following intravenous administration may be deleterious in some patients.

Original languageEnglish (US)
Pages (from-to)318-330
Number of pages13
JournalAmerican Heart Journal
Volume78
Issue number3
DOIs
StatePublished - Sep 1969

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Cardiogenic Shock
Digitalis
Ventricular Pressure
Blood Vessels
Atrial Pressure
Intravenous Administration
Deslanoside
Cardiac Glycosides
Digoxin
Vasoconstrictor Agents
Ouabain
Pulmonary Edema
Isoproterenol
Cardiac Output
Vascular Resistance
Hemodynamics
Stroke

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Cardiac and peripheral vascular effects of digitalis in clinical cardiogenic shock. / Cohn, Jay N.; Tristani, Felix E.; Khatri, Ibrahim M.

In: American Heart Journal, Vol. 78, No. 3, 09.1969, p. 318-330.

Research output: Contribution to journalArticle

Cohn, Jay N. ; Tristani, Felix E. ; Khatri, Ibrahim M. / Cardiac and peripheral vascular effects of digitalis in clinical cardiogenic shock. In: American Heart Journal. 1969 ; Vol. 78, No. 3. pp. 318-330.
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