ABSTRACT
The article deals with the data of echocardiographic examination of 61 patients (37 with rheumatic heart disease and 17 with atherosclerotic cardiosclerosis) subjected to rapid stage-by-stage digitalization by intravenous administration of various rapidly acting glycosides. In 10 patients with ischemic heart disease echocardiography was performed following a single strophanthin injection. Decrease in the volumes of the left ventricle and increase in the indices of central hemodynamics were noted as a result of rapid stage-by-stage saturation with strophanthin. The maximum inotropic effect of strophanthin does not coincide in time with the maximum chronotropic effect. The increase in the stroke volume noted in maximum deceleration of cardiac contractions is probably realized due to the Frank-Starling mechanism. Strophanthin increases the rate of myocardial contractions without changing the duration of the systole. The rate of diastolic relaxation grows, the phase of rapid filling becomes shorter and the phase of slow filling longer, which creates favourable conditions for the next contraction.
Subject(s)
Cardiac Glycosides/administration & dosage , Myocardial Contraction/drug effects , Adult , Aged , Cardiac Glycosides/pharmacology , Cardiac Glycosides/therapeutic use , Coronary Disease/drug therapy , Coronary Disease/physiopathology , Echocardiography , Female , Humans , Injections, Intravenous , Male , Middle Aged , Rheumatic Heart Disease/drug therapy , Rheumatic Heart Disease/physiopathologyABSTRACT
An analysis of archives material (1,500 case reports of patients with circulatory insufficiency) revealed that 200 patients (13%) had persistent, refractory circulatory failure. The revealed factors providing for the development of the refractoriness were: relapsing rheumocarditis, pneumonias, pulmonary infarctions in patients with rheumatic heart diseases, extended cicatrical changes in the myocardium of patients with atherosclerotic cardiosclerosis, or the underlying pathological process in cases of idiopathic myocardial lesions. These factors were taken into account, along with individualization of the therapeutic regimens of cardiac glycosides.
