Korean Circ J.  1981 Jun;11(1):35-53. 10.4070/kcj.1981.11.1.35.

A Study on Clinical Effects and Serum Concentration of Digoxin

• Kim MS
• Lee SH
• Lee YW

• KMID: 1668343
• DOI: http://doi.org/10.4070/kcj.1981.11.1.35

Abstract

From mechanocardiography and echocardiography, the systolic time intervals and the ejection phase indices were measured with determination of serum digoxin concentration(SDC) to elucidate the value of oral maintenance digoxin therapy on patients with heart failure in sinus rhythm. The drug interactions of digoxin with quinidine in heart failure, with verapamil in atrial fibrillation, and with aluminium hydroxide gel in healthy volunteers were observed with concomitant changes of SDCs. The results obtained are as follows. 1. After 10 days of treatment with digoxin 0.25 mg/day in 21 patients with heart failure there was a significant decrease in electromechanical systole(QS2), pre-ejection period(PEP) and PEP/left ventricular ejection time(LVET) ratio. There was also and equivocal decrease in LVET and an equivocal increase in mean velociy of circumferential fiber shortening(Vcf). However there was no significant change in ejection fraction(EF) and heart rate. The steadystate SDC was 1.20+/-0.12(S.E.M.)ng/ml. 2. Excellent correlation of the systolic time interval sand ejection phase indices measured from mechanocardiography and those determined from echocardiography was demonstrated. 3. SDCs were measured before and following quinidine therapy in 20 patients receiving maintenance digoxin for heart failure and who require quinidine for suppression of ventricular premature beats. Steady-state SDC following quinidine(Y) could be estimated form steady-state SDC before quinidine(X) as expressed by regression equation, Y=-0.394+2.309 X with correlation coeffcient, r=0.927(p<0.01). 4. In 12 patients with atrial fibrillation receving maintenance digoxin 0.25 mg/day, SDC before and following coadministration fo first 160 mg/day and later 240 mg/day of verapamil for 7days on each occasion was 0.85+/-0.07(S.E.M.) ng/ml, 1.00+/-0.09(S.E.M.)ng/ml and 1.33+/-0.13(S.E.M.)ng/ml, respectively. The difference of SDC between at control and under 240mg/day of verapamil was significant statistically(p<0.05). 5. Digoxin 0.75mg single-dose studies of bioavailability in 11 healthy volunteers showed a statistically significant difference(p<0.05) of the area under the 8-hour SDC curve between the digoxin only group and the digoxin plus aluminium hydroxide gel group. The area under the curve was 680+/-25(S.E.M.) min*ng/ml and 509+/-29(S.E.M.) min*ng/ml, respectively.

MeSH Terms

Atrial Fibrillation
Biological Availability
Cardiac Complexes, Premature
Digoxin*
Drug Interactions
Echocardiography
Healthy Volunteers
Heart Failure
Heart Rate
Humans
Quinidine
Silicon Dioxide
Systole
Verapamil
Digoxin
Quinidine
Silicon Dioxide
Verapamil