[The use of digitalis preparations in cases of disturbed cardiac conduction (author's transl)].
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The Bulgarian digitalis preparation Digilanid C for venous application has a satisc factory effect on the majority of the patients (67 per cent) with light and moderate chronic cardia insufficiency and espically in case of tachycardia in auricular fibrillation. The comparison of the results between the group of 46 patients, treated with Digilanid C and the control group of 20 patients treated with Isolanid (Richter) do not reveal essential differences in the major part of the results obtained.
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For long time, there has been controversy on the use of digitalis in acute myocardial infarction (AMI). Hemodynamic studies before and after the use of cedilanid, simple QRS scoring, changes on the score of AMI and cardiac arrhythmia were analysed on 24 cases of AMI. Results of the pre- and post-medication values were improved as following: (1) Cardiac index (CI) were 2.34 +/- 0.2 and 3.21 +/- 0.26L/min/m2 two hours after medication (P < 0.05). (2) Left ventricular stroke work index (LVSWI) were 31.2 +/- 3.4 and 40.1 +/- 2.2 g-m/beat/m2 two hours after medication (P < 0.01). (3) Pulmonary capillary wedge pressure (PCWP) were 19.5 +/- 2.4 and 13.2 +/- 2.1 mmHg two hours after medication (P < 0.01). (4) Myocardial oxygen consumption triple index (TI) were 182000 +/- 14000 and 142000 +/- 12000 two hours after medication (P < 0.01). (5) There was no change or with only trivial aberration on systemic vascular resistance (SVR) and perfusion pressure of the coronary arteries (CCP). (6) Simple QRS scoring on electrocardiogram resulted that the size of infarcted areas were 4.02 +/- 0.3 points before and 3.01 +/- 0.23 points after the medication (P < 0.01), there was neither ventricular premature beats (VPB) nor increase of any other serious cardiac arrhythmias in the electrocardiogram care and record in 72 hours. From the hemodynamic studies, the beneficial effect of cedilanid is greater than its adverse effect. It is concluded that digitalis can be safely and effectively used in the treatment of AMI.
Administration of cycloartane (askendoside D-10 mg/kg, cyclosiversioside F-25 mg/kg) and heart glycosides (strophanthin K-0.36 mg/kg, celanide-1 mg/kg) for 3-10 days is found to exert unidirectional effect on the indices of carbon, lipid and adenine nucleotide metabolism in animal myocardium under study. Glycogen and ATP content increases under parallel decrease of lactate and nonesterified fatty acid content. Differences in the effect of cycloorthane and heart glycosides and especially on the indices of myocardial carbon metabolism were registered under more prolonged administration. Administration of heart glycosides in contrast to cycloorthane ones promotes a decrease of glycogen level and redox potential and increase of lactate content.
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Acute teste staged on rats showed low doses of the cardiac glycoside isolanide to bring down the level of total lipids, cholesterol and beta-lipoproteins, without causing any changes in the content of NAD, adenyl nucleotides, non-esterified fatty acids (NEFA) and of phospholipids in themyocardium. Large doses of the drug uniformly reduce the content of all the co-enzymes fractions, the amount of ARP, ADP, cholesterol, beta-lipoproteins and the raise the level of total lipids, phospholipids and NEFA. In cases of acute cardiac insufficiency the drug produces a normalizing action on the co-enzymes and adenyl nucleotides content and reduces that of beta-lipoproteins and cholesterol. It appears that a definite part in the mechanism of the isolanide action plays its influence on the level of nucotinamide co-enzymes, adenyl nucleotides and lipids.
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