No coin nor oath required. For personal study only.
Digoxin (D) can differently affect heart rhythm. 46 patients (pts) with CHF II-III NYHAFC (DCMP-26, RVD-14, and IHD-6) taking D therapy were studied. Pts took D during 6-12 months, then drug was discontinued, and in 5 days after this it was intravenously injected during 7-10 days in dose 0,75 rag daily. Holter monitoring during 24 hours and determination of D threshold concentration (TC) in vitro conditions using fluorescent probe dis-C3-(5) were carried out at each step of study. Under the influence of DTC transition from stimulating to inhibiting effect on the platelet membrane Na+/K+-ATPase activity observed. DTC indices fluctuated from 10 -7 to 10 -5 M, in most cases accounting for 10-6 M in pts with absence of D influence on heart rhythm; increase of TDC up to 10 -5 Munder antiarrhythmic effect, and the decrease to i0 -8M under proarrhythmic effect of D were measured.
Discrepancy in the DTC indices possibly showed differences in affinity of D to platelet membrane Na+/K+-ATPase, proved the role of individual sensibility of specific receptors to D in CHF pts in the differences of drugs action on the heart rhythm.
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