Hemodynamic effects Of Dixogin in acute myocardial infarction

Hemodynamic effects of 0.50 mg of i.v. Digoxin were studied in 25 patients (18 males and seven females, with a mean age of 66.0 ± 8.7 years) with an acute myocardial infarction (AMI) who underwent a right heart catheterization and hemodynamic monitoring in the CCU. Heart rate (HR) was reduced from 97.16 ± 16.41 to 91.00 ± 16.85 beals/min (P < 0.01); cardiac index (CI) increased from a mean value of 2.16 ± 0.49 to 2.55 ± 0.70 l/min/m2 (P < 0.001); stroke index (SI) and left ventricular stroke work index (SWI) also improved from 22.46 ± 4.11 to 28.44 ± 7.61 ml/m2 and from 27.52 ± 5.71 to 36.04 ± 9.65 gm-m/m2 (P < 0001). Systolic (SAP) and diastolic (DAP) arterial pressure slightly but significantly increased (P < 0.01) from 121.56 ±16.61 and 75.08 ± 9.03 mm Hg respectively, to 126.80 ± 16.28 and 77.72 ± 9.25 mm Hg; pulmonary artery mean pressure (PMP) decreased from 22.30 ± 8.22 to 20.48 ± 5.47 mm Hg (P < 0.05). The patients were subdivided into two hemodynamic classes, according to the values of the PMP measured in basal conditions: group 1 (PMP ≤ 19 mm Hg): 11 patients (44.0%); group 2 (PMP > 19 mm Hg): 14 patients (56.0%). Hemodynamic effects of i.v. Digoxin were analysed separately in each class, and the results were compared. No difference was observed between the data from the two groups, except for PMP. This parameter was unchanged after Digoxin in group 1, while in group 2 it was reduced from 26.39 ± 5.29 to 23.18 ± 5.76 mm Hg. Furthermore, HR did not vary and DAP significantly increased only in group 1 (hypovolemic patients) while HR significantly decreased and DAP remained unchanged in the group of patients with a PMP > 19 mm Hg. We concluded that Digoxin treatment during AMI can favourably affect the circulatory conditions primarily in cases with a moderate left ventricular failure. The beneficial effects of the drug seemed to be less evident when administered to patients with almost normal pump function or with extreme degrees of left ventricular failure.