SVIBOR - Project code: 3-01-235

MINISTRY OF SCIENCE AND TECHNOLOGY

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SVIBOR

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Project code: 3-01-235


OPTIMAL HEART FAILURE INOTROPIC TREATMENT STUDY


Main researcher: POLIĆ, STOJAN (77340)


Assistants
Type of research: applied
Duration from: 11/01/91. to 12/31/94.
Papers on project (total): 38
Papers on project quoted in Current Contents: 5
Institution name: Bolnica "Firule", Split (141)
Department/Institute: DEPARTMENT OF CARDIOANGIOLOGY DEPARTMENT OF MEDICINE CLINICAL HOSPITAL SPLIT
Address: Spinčićeva 1, 58 000 Split, Croatia
City: 21000 - Split, Croatia
Communication
Phone: 385 (0)21 515055
Fax: 385 (0)21 356738
Summary: Regardless of the fact that cardiotonic agents have been used for almost two hundred years in clinical practice, their real effect in the treatment of heart failure, is still unknown. Because of their straight therapeutic window, the prevalence of intoxication (including the mortality rate), is relativly high. Aims of this investigation are: 1. to determine the most ration al choice of digitalis agents in treatment of congestive heart failure, 2. to try (by using amiloride) to influence positively on decrease of such a high rate of digoxin intoxication. This study is planned to be cross-over, double-blind, and realized through the two separate trials. In the first part, the efficiency of polar digoxin, and non-polar digitoxin in the treatment of heart failure combined with either sinus rhythm or supraventricular tachyarrhythmia, will be compared. In the second part of the study, a possible effect of diuretic amiloride on the prevalence of digoxin intoxication will be assessed. The results of this investigation could enable an rational therapeutic approach to the congestive heart failure, one of the most prevalent cause of cardiovascular mortality. New therapy strategies could directly influence on decrease of mortality rate of our patients.

Keywords: DIGOXIN, DIGITOXIN, AMILORIDE, POLAR AND NON-POLAR CARDIAC GLYCOSIDES, HEART FAILURE, RATIONAL THERAPY

Research goals: 1. To determine inotropic effect and atrioventricular conductance of digoxin and digitoxin in patients with congestive heart failure accompanied by sinus rhythm or with atrial fibrillation/undulation. 2. We expect that digitoxin, because of its liposolubility, by central sympathetic stimulation, could produce better inotropic response, and accordingly, better efficiency in the treatment of congestive heart failure with sinus rhythm, than digoxin. On the other side, digoxin, being hydrosolubile and because of its high fraction of free, unbound drug, could better effect the peripheral receptors and in the treatment of heart failure combined with supraventricular tachyarrhythmias, thus produce better results than digitoxin. 2. To assess the role of amiloride in the treatment of digitalized cardiopaths, and a possible influence on decrease of intoxication rate. It is our hypothesis that this drug, contrary to other diuretics, decreases the incidence of digitalis intoxication.

COOPERATION - PROJECTS


  1. Name of project: 3-01-238 Izučavanje etiopatogeneze, dijagnostike i terapije hipertenzije
    Name of institution: Klinička bolnica Split
    City: 21000 - Split, Croatia

COOPERATION - INSTITUTIONS


  1. Name of institution: Medical College of Wisconsin
    Type of institution: Economical/Production
    City: Millwaukee, USA
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