Optimierte Digitalistherapie - Therapiestudie zu Klinik, Befinden und Herzdynamik bei Herzinsuffienz
Journal/Book: Therapiewoche. 1987; 37: 401-412.
Abstract: Fifty patients with heart failure in all NYHA-classes were treated with the digitalis glycoside Gitoformat in order to determine their individual dosage. The elimination of Gitoformat is independent of kidney function. The therapeutic course was observed on the basis of non-invasive measurement of dynamic cardiac parameters, clinical observations and assessment of the patient's well-being. After the maintenance dose had been planed according to body weight, it was then varied in 20% of the patients. As a result of retrospective evaluation, the digitalis serum levels were shown to be inadequate to set an individual dose whereas the usual clinical parameter - in particular dyspnea with an improvement score of 1,1 ± 1,0 (p < 0,0001) - were found to be very suited. By taking the assessment of the patient's wellbeing into account the maintenance dose could be further adjusted. By forming groups, a change like a normalization within a collective was observed in the LVETc-values: initial times > 230 ms fall by -13,9±15,5 ms (p < 0,0001) and initial values < 230 ms increased by 19,1 ± 25,9 ms (p < 0,05). The broad significance of dyspnea in heart failure with respect to both the LVET and the well-being of the patient is demonstrated.