An Update on the Role of Digoxin in Older Adults with Chronic Heart Failure



Geriatrics and Aging. 2008;11(1):37-41. 

In This Article

Treatment of Heart Failure: Digitalis

Digitalis glycosides, discovered first by 18th-century English physician Dr. William Withering and derived from the leaves of the foxglove plant, are among the oldest cardiovascular drugs.[17,18] Long known as a positive inotrope, digoxin (obtained from Digitalis lanata) acts by improving the contractile function of both the failing and normal heart.[19] At the cellular level, digitalis inhibits the sodium-potassium adenosine triphosphatase enzyme, thus increasing the intracellular concentration of calcium. However, digoxin also acts as neurohormonal modulator, and much of the beneficial effects of digoxin may be due to its neurohormonal suppressing properties.[6] Digoxin is approved by the U.S. Food and Drug Administration for use in chronic HF and is recommended for use by the Canadian Cardiovascular Society guideline for diagnosis and management of HF.[20,21,22] Digoxin is the most commonly used digitalis and was the digitalis used in the Digitalis Investigation Group trial, the only randomized clinical trial of digitalis in chronic HF.[23]


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