Objectives Although development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issue which could be easily overlooked. In this report, we analyzed a case series definitiv...Objectives Although development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issue which could be easily overlooked. In this report, we analyzed a case series definitively diagnosed as digoxin intoxication in the modern era. Methods We analyzed 71 patients hospitalized with digoxin intoxication confirmed by history, complaints, clinical and electrocardiograph （ECG） findings, and serum digoxin levels 〉 2.0 ng/mL, during a five year period. The demographic and clinical data, indications for digoxin use, digoxin dosage, concurrent medications, laboratory data, hospital monitoring, and ECG findings were obtained from all patients. Results Thirty-eight of 71 patients （53.5%） had symptoms of heart failure during admission or later. Sixty-four percent of patients were older than 75 years. The percentage of females was 67%. Atrial fibrillation, hypertension and gastrointestinal complaints were more frequent in the females （64% in females, 30% in males, P = 0.007; 81% in female, 52% in males, P = 0.01; 50% in female, 17.3% in males, P = 0.008, respectively）. The mortality rate during the hospital course was 7%. Conclusions This report demonstrated the reduced mortality rates in patients with digoxin intoxication over the study period. Gastrointestinal complaints are the most common symptoms in this population.展开更多
Objective To compare the effects of ouabain and digoxin on the gene expression of sodium pump α-subunit isoforms in the myocardium of rats.Methods Normal Sprague-Dawley (SD) rats were injected with ouabain (20 μg&...Objective To compare the effects of ouabain and digoxin on the gene expression of sodium pump α-subunit isoforms in the myocardium of rats.Methods Normal Sprague-Dawley (SD) rats were injected with ouabain (20 μg· kg-1· d-1, i.p. ), digoxin (32 μg· kg-1· d-1, i.p. ) and normal saline (NS) once a day, respectively, and indirect systolic blood pressure was recorded once a week. Six weeks later, all of the rats were killed, and sodium pump α1-,α2-, and α3-subunit mRNA levels in the myocardium were detected with the reverse transcription polymerase chain reaction (RT-PCR) method.Results The systolic blood pressure of the rats infused with ouabain increased significantly at the end of week 6 ( 132.6 ± 9.0 mm Hg vs 115.7 ± 8.2 mm Hg, P ＜ 0.01 ), while no difference in blood pressure was found between the digoxin group and the NS group. The expression of sodium pump α-subunit isoforms in the ventricular myocardium was regulated by either ouabain or digoxin. Both ouabain and digoxin stimulated expression of the α3-isoform, whereas o2 was uncharcged in those two groups. α1-isoform expression decreased in the ouabain group and was unchanged in the digoxin group.Conclusions These results suggest that both ouabain and digoxin could regulate sodium pump α-subunit isoform expression, which might be related to the physiological roles of endogenous ouabain and might be responsible for the difference in the pharmacological and toxicological effects of ouabain and digoxin,including their effects on blood pressure.展开更多
Objective To investigate the different effects of an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, losartan, and an angiotensin converting enzyme (ACE) inhibitor, fosinopril, on cardiomyocyte apoptosis, myocardi...Objective To investigate the different effects of an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, losartan, and an angiotensin converting enzyme (ACE) inhibitor, fosinopril, on cardiomyocyte apoptosis, myocardial fibrosis, and angiotensin Ⅱ (AngⅡ) in the left ventricle of spontaneously hypertensive rats (SHRs) Methods SHRs of 16 week old were randomly divided into 3 groups: SHR L (treated with losartan, 30 mg·kg 1 ·d 1 ), SHR F (treated with fosinopril, 10 mg·kg 1 ·d 1 ), and SHR C (treated with placebo) Each group consisted of 10 rats Five rats, randomly selected from each group, were killed at the 8th and 16th week after treatment Cardiomyocyte apoptosis, collagen volume fraction (CVF), perivascular collagen area (PVCA) and AngⅡ concentrations of plasma and myocardium were examined Results Compared with the controls at the 8th and 16th week, systolic blood pressures were similarly decreased in both treatment groups Left ventricular weight and left ventricular mass indexes were significantly lower in both treatment groups However, the latter parameter at the 16th week was reduced to a less extent in the fosinopril group than that in the losartan group Compared with the controls, cardiomycyte apoptotic index was significantly reduced at the 8th week only in the fosinopril group, and at the 16th week in both treatment groups The index of the fosinopril group was lower than that of the losartan group at the latter endpoint examined Compared with the controls, the left ventricular collagen volume fraction and perivascular collagen area at the 8th and 16th weeks were significantly reduced in the SHRs treated with either fosinopril or losartan However, the collagen volume fraction at the latter endpoint in the fosinopril group was lower than that in the losartan group Compared with the controls at endpoints, plasma and myocardium Ang Ⅱ levels were significantly increased in the losartan group However, plasma Ang Ⅱ concentrations were not altered, and myocardium AngⅡ concentrations at the 8th and 16th weeks were significantly reduced in the fosinopril group Conclusions Both losartan and fosinopril could effectively inhibit cardiomyocyte apoptosis and myocardial fibrosis and reverse heart hypertrophy Fosinopril may be more effective in these cardioprotective effects, suggesting that the effects of both drugs are related to the inhibition of myocardium renin angiotension aldsterone system展开更多
文摘Objectives Although development of new treatment modalities limited digoxin usage, digoxin intoxication is still an important issue which could be easily overlooked. In this report, we analyzed a case series definitively diagnosed as digoxin intoxication in the modern era. Methods We analyzed 71 patients hospitalized with digoxin intoxication confirmed by history, complaints, clinical and electrocardiograph （ECG） findings, and serum digoxin levels 〉 2.0 ng/mL, during a five year period. The demographic and clinical data, indications for digoxin use, digoxin dosage, concurrent medications, laboratory data, hospital monitoring, and ECG findings were obtained from all patients. Results Thirty-eight of 71 patients （53.5%） had symptoms of heart failure during admission or later. Sixty-four percent of patients were older than 75 years. The percentage of females was 67%. Atrial fibrillation, hypertension and gastrointestinal complaints were more frequent in the females （64% in females, 30% in males, P = 0.007; 81% in female, 52% in males, P = 0.01; 50% in female, 17.3% in males, P = 0.008, respectively）. The mortality rate during the hospital course was 7%. Conclusions This report demonstrated the reduced mortality rates in patients with digoxin intoxication over the study period. Gastrointestinal complaints are the most common symptoms in this population.
基金ThisstudywassupportedbyagrantfromtheNationalNaturalScienceFoundationofChina (No 396 70 32 5 )
文摘Objective To compare the effects of ouabain and digoxin on the gene expression of sodium pump α-subunit isoforms in the myocardium of rats.Methods Normal Sprague-Dawley (SD) rats were injected with ouabain (20 μg· kg-1· d-1, i.p. ), digoxin (32 μg· kg-1· d-1, i.p. ) and normal saline (NS) once a day, respectively, and indirect systolic blood pressure was recorded once a week. Six weeks later, all of the rats were killed, and sodium pump α1-,α2-, and α3-subunit mRNA levels in the myocardium were detected with the reverse transcription polymerase chain reaction (RT-PCR) method.Results The systolic blood pressure of the rats infused with ouabain increased significantly at the end of week 6 ( 132.6 ± 9.0 mm Hg vs 115.7 ± 8.2 mm Hg, P ＜ 0.01 ), while no difference in blood pressure was found between the digoxin group and the NS group. The expression of sodium pump α-subunit isoforms in the ventricular myocardium was regulated by either ouabain or digoxin. Both ouabain and digoxin stimulated expression of the α3-isoform, whereas o2 was uncharcged in those two groups. α1-isoform expression decreased in the ouabain group and was unchanged in the digoxin group.Conclusions These results suggest that both ouabain and digoxin could regulate sodium pump α-subunit isoform expression, which might be related to the physiological roles of endogenous ouabain and might be responsible for the difference in the pharmacological and toxicological effects of ouabain and digoxin,including their effects on blood pressure.
文摘Objective To investigate the different effects of an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, losartan, and an angiotensin converting enzyme (ACE) inhibitor, fosinopril, on cardiomyocyte apoptosis, myocardial fibrosis, and angiotensin Ⅱ (AngⅡ) in the left ventricle of spontaneously hypertensive rats (SHRs) Methods SHRs of 16 week old were randomly divided into 3 groups: SHR L (treated with losartan, 30 mg·kg 1 ·d 1 ), SHR F (treated with fosinopril, 10 mg·kg 1 ·d 1 ), and SHR C (treated with placebo) Each group consisted of 10 rats Five rats, randomly selected from each group, were killed at the 8th and 16th week after treatment Cardiomyocyte apoptosis, collagen volume fraction (CVF), perivascular collagen area (PVCA) and AngⅡ concentrations of plasma and myocardium were examined Results Compared with the controls at the 8th and 16th week, systolic blood pressures were similarly decreased in both treatment groups Left ventricular weight and left ventricular mass indexes were significantly lower in both treatment groups However, the latter parameter at the 16th week was reduced to a less extent in the fosinopril group than that in the losartan group Compared with the controls, cardiomycyte apoptotic index was significantly reduced at the 8th week only in the fosinopril group, and at the 16th week in both treatment groups The index of the fosinopril group was lower than that of the losartan group at the latter endpoint examined Compared with the controls, the left ventricular collagen volume fraction and perivascular collagen area at the 8th and 16th weeks were significantly reduced in the SHRs treated with either fosinopril or losartan However, the collagen volume fraction at the latter endpoint in the fosinopril group was lower than that in the losartan group Compared with the controls at endpoints, plasma and myocardium Ang Ⅱ levels were significantly increased in the losartan group However, plasma Ang Ⅱ concentrations were not altered, and myocardium AngⅡ concentrations at the 8th and 16th weeks were significantly reduced in the fosinopril group Conclusions Both losartan and fosinopril could effectively inhibit cardiomyocyte apoptosis and myocardial fibrosis and reverse heart hypertrophy Fosinopril may be more effective in these cardioprotective effects, suggesting that the effects of both drugs are related to the inhibition of myocardium renin angiotension aldsterone system
