k-strophanthin-beta and Coronary-Disease

To evaluate the effects and safety of intermittent strophanthin K therapy (ISKT) for congestive heart failure combined coronary artery disease with sinus rhythm.. Two hundred patients divided into Group A (98 cases with maintenance digoxin therapy) and Group B (102 cases with ISKT). They were studied for 3 months and some of them for longer period.. Comparing the pretreatment data: 1. heart rate (HR, bpm), 2. left ventricular ejection fraction (LVEF), 3. blood pressure (Bp, mmHg, calculated values as mean Bp for statistics). In group A, item 1. and 2. were significantly improved (item 1. 88 +/- 12 and 68 +/- 12, P < 0.01; item 2. 0.32 +/- 0.12 and 0.40 +/- 0.12, P < 0.01; item 3. showed no significant difference (126 +/- 21/90 +/- 6 and 128 +/- 21/80 +/- 5, P > 0.05). In group B, item 1., 2. and 3. were significantly improved (item 1. 90 +/- 10 and 70 +/- 11, item 2. 0.32 +/- 0.10 and 0.45 +/- 0.10, item 3. 128 +/- +/- 20/91 +/- 7 and 110 +/- 10/76 +/- 10, the p valves are the same < 0.01). As compared with the posttreatment data of both group A and B, HR, P > 0.05, there was no significant difference, LVEF, P < 0.05, there was significant difference, Bp, P < 0.01, there was significant difference. It showed no significant difference in total occurrence rate of digitalis overload or toxication between two groups also.. ISKT for congestive heart failure combined coronary artery disease with sinus rhythm is effective and safe, with better improvement of heart function and Bp level.

Topics: Adult; Cardiotonic Agents; Coronary Disease; Female; Heart Failure; Humans; Male; Middle Aged; Strophanthins

In 10 patients with coronary artery disease, preserved left ventricular (LV) performance and absence of previous myocardial infarction, the effects of an acute intravenous administration of k-strophantidin (0.005 mg/kg over 10 minutes) on selected parameters of both LV systolic and diastolic function, including relaxation, were evaluated. An increase in positive first derivative of LV pressure (dP/dt) and in the ratio between dP/dt and the pressure developed (dP/dt/P) (1,530 +/- 287) 1,600 +/- 329 mm Hg/s [p less than 0.05], and 30 +/- 6 to 34 +/- 8 s-1 [p less than 0.05], respectively) demonstrated the inotropic effect of k-strophantidin, whereas volumetric parameters of systolic function (end-systolic and stroke volume indexes, and ejection fraction) did not show any significant change. However, LV relaxation was impaired by k-strophantidin injection; in fact, mean values of T constant were significantly increased from 50 +/- 12 to 55 +/- 13 ms (p less than 0.01). Lowest LV and end-diastolic pressures increased from 8 +/- 4 to 11 +/- 4 mm Hg (p less than 0.05) and from 17 +/- 6 to 20 +/- 8 mm Hg (p less than 0.05), respectively. The end-diastolic volume and maximal rate of volumetric increase during the early and late filling phases were not modified by k-strophantidin. Mean aortic pressure increased from 110 +/- 10 to 120 +/- 12 mm Hg (p less than 0.001). Therefore, in patients with coronary artery disease and LV preserved performance, an acute intravenous administration of k-strophantidin appears to stimulate contractility and to worsen relaxation, and minimal LV and end-diastolic pressures.

Topics: Aged; Coronary Disease; Diastole; Female; Humans; Injections, Intravenous; Male; Middle Aged; Strophanthins; Ventricular Function, Left

The effects of digitalis on the left ventricular diastolic phase are very scant. In order to gain a better insight into this problem, we measured the hemodynamic effects of an intravenous injection of K-strophantidin (0.005 mg/kg in a bolus given within 5-10 min) during the diastolic phase in 9 normal male subjects and in 9 male patients with coronary artery disease (CAD), maintaining a normal overall ejection fraction despite of the presence of some hypokinetic segments. Administration of K-strophantidin decreased significantly in normal controls the left ventricular volumes at 1/3, 1/2, 2/3 of the diastolic phase, whereas it did not produce significant change in CAD patients. Digitalis decreased the first and increased the second filling peak of the volumetric variable dV/dt in the normal controls, but not in the CAD patients. In the latter group the 2 peaks before digitalis administration were similar. The effects of digitalis on the dV/dt measured during the second filling peak were significantly different in the 2 groups. The increments of pressure in middle and end diastole in CAD patients were significantly greater than those observed in normal controls. Results of the present study suggest that digitalis has a negative influence on the left ventricular filling phase both in normal and CAD subjects. In fact digitalis modifies in normals the pattern of the left ventricular filling phase whereas it induces an untoward increase in the middle and end diastolic pressure in CAD patients.

Topics: Adult; Angiography; Coronary Disease; Humans; Male; Middle Aged; Stroke Volume; Strophanthins

It was shown in experiments on random-bred rats that changes in the heart reactivity caused by adrenaline, rausedyl, potassium chloride and strophanthine facilitate the occurrence of cardiac rhythm abnormalities during the creation of the generator of pathologically enhanced excitation (GPEE) in the anterior amygdaline nucleus. The moments of rhythm abnormalities correlate with the occurrence of GPEE epileptic activity. Meanwhile the pattern of cardiac rhythm abnormalities is largely determined by the specificity of action of the pharmacological substances indicated. Analogous effects of cardiac rhythm abnormality facilitation during GPEE creation in the nucleus were obtained in myocardial ischemia caused by the occlusion of the anterior or posterior left coronary artery. At the same time the differences were recorded in the pattern of cardiac rhythm abnormalities depending on the area of ischemia. The data obtained are discussed in the light of concepts of regulation diseases, particularly of the correlation between the role of determinant structures and reactivity disorders in the target organs.

Topics: Amygdala; Animals; Coronary Disease; Coronary Vessels; Epinephrine; Heart; Heart Rate; Ligation; Potassium Chloride; Rats; Reserpine; Strophanthins

Hemodynamic effects of K-strophanthin (0.005 mg/kg i.v.) were evaluated in 7 normal and in 13 non-failing coronary artery disease patients (CAD). Volumetric parameters were obtained by single plane left ventricular angiography. The indexes of "pump" function, the end-systolic pressure-volume relationship and the ratio of peak pressure to systolic volume were also evaluated. Heart rate was maintained constant by atrial pacing. In normal subjects K-strophanthin exerted small effects without peripheral vasoconstriction. CAD patients showed different response to K-strophanthin in vascular tone: an increase (Group 1) or a decrease (Group 2) in total systemic resistance (TSR). No significant differences were found in basal values between the two CAD groups. In Group 2 the indexes of "pump" function increased after K-strophanthin and the end-systolic pressure-volume points shifted upward and to the left, while in Group 1 no improvement in cardiac function was observed and the end-systolic pressure-volume points shifted upward and to the right. Furthermore, we found a direct significant correlation between the percent changes of TSR and end-systolic volume index, and a negative significant correlation between the percent changes of TSR and stroke volume index. Our results show that K-strophanthin in CAD non-failing patients can have either a positive effect or a lack of improvement in ventricular performance. These effects correlate with changes in total systemic resistance.

Topics: Adult; Coronary Disease; Hemodynamics; Humans; Male; Middle Aged; Strophanthins