Is digitalis currently useful for heart failure treatment?

Main Article Content

José F Guadalajara-Boo, MD, FACC, FAHA


Foxglove has been used for over 200 years to reduce water retention in its early days; Since the end of the 19th century, the treatment of heart failure has shown good clinical results. At the beginning of the 20th century, the treatment of heart failure began with good results and in the middle of the century scientific studies were carried out to determine the direct effects on the heart. 10 years later, clinical experience and technological advances demonstrated a really good efficacy that the digitalis effect had for the failing heart, with a defect: it is an old drug that appears obsolete for its current management in the presence of great new drugs that have proven useful in heart failure.

From the last third of the 20th century, it was shown that the heart benefits from the combination are better than the drugs alone, so digitalis has a role that, in combination with the other drugs, significantly enhances the beneficial effects for the treatment of heart failure.

Article Details

How to Cite
GUADALAJARA-BOO, José F. Is digitalis currently useful for heart failure treatment?. Medical Research Archives, [S.l.], v. 10, n. 3, apr. 2022. ISSN 2375-1924. Available at: <>. Date accessed: 28 nov. 2022. doi:
Research Articles


1. Chávez I. “La digitalina a pequeñas dosis, en el tratamiento de las cardiopatías”. Tesis recepcional. Facultad de Medicina. Universidad Nacional Autónoma de México. Abril 1920.

2. The digitalis investigation group investigators. “The effects of digoxin on mortality and morbidity in patient whit heart failure”. N Eng J Med. 1997;336:525-33.

3. E. Braunwald, LI. Goldberg, A.G. Morrow. “Studies on digitalis. IV. Observations in man on the effects of digitalis preparations on the contractility of the non-failing heart and on total vascular resistance”. J Clin Invest. 1961;4:52-9.

4. Mason DT. Braunwald E. “Studies on digitalis. X. Effects of ouabain on forearm vascular resistance and venous tone in normal subjets and in patients in heart failure”. J Clin Invest. 1964;43:532-8.

5. Vatner SF, Braunwald E. “Effects of chronic heart failure on the inotropic response of the right ventricle of the conscious dog to a cardiac glycoside and to tachycardia”. Circulation. 1974;50:728-34.

6. Braunwald E. “Control of myocardial oxygen consumption: physiologic and clinical considerations”. Am J Cardiol. 1971;27:416-32.

7. Covell JW, Braunwald E, Ross I, Sonnenblick EH. “Studies on digitalis. XVI Effects on myocardial oxygen consumption”. J Clin Investig. 1966;45:1535-41.

8. Kumar R, Hood Jr WB, Jouson J, Gilmour DP, Normal JC. y Abelmann WH. “Experimental myocardial infarction. VI Efficacy and toxicity of digitalis in acute and healing phase in intact conscious dogs”. J Clin Invest. 1970;49:358-64.

9. Cotten MD. y Stopp PE. ”Action of digitalis on the nonfailing heart of the dog. Am J Physiol”. 1958;192:114-20.

10. Hood Jr WB, Letac B, Roberge G, y Lown B. “Direct digitalization of the myocardium. Hemodynamic effects”. Am J Cardiol. 1968;22:667-75.

11. Volpi A, De Vita C, Franzoci MG, Geraci E, Mauri F, Negri E, et al. “Determinant of six-monts mortality in survivors of myocardial infarction alter thrombolisys results of the GISSI-2 Database. Circulation. 1993;88:416-29.

12. Curtis JP, Sokil SI, Wang Y, Rathore SS, Ka DT, Jadbaba F. The Association of left ventricular ejection fraction mortality as cause of death in stable out patients with heart failure”. Am J Coll Cardiol. 2003;42:736-42.

13. Aronow WS, Ahn C, Kronson I. “Prognosis of congestive heart failure in elderly patient in normal vs abnormal left ventricular systolic function associated with coronary artery disease”. Am J Cardiol. 1990;66:1257-59.

14. Cohn JN, Rector TS. “Prognosis of Congestive Heart Failure and Predictors on Mortality”. Am J Cardiol. 1988;62:25A-30A.

15. Tauke J, Goldstein S. y Gheorghiade M. “Digoxin in chronic heart failure a review of randomized controlled trials with special attention to the Proved and Radiance Trial”. Prog Cardiovasc Dis. 1994;37:49-58.

16. Gheorghiade M. y Ferguson D. Digoxin. “A neurohormonal modulatior in heart failure”. Circulation 1991;842181-6.

17. Van Velhuisen M, Graeff PA, Remme WJ, Lie KI. “Value of digoxin in heart failure and sinus rhythm; new features of an old drug”. J Am Coll Cardiol. 1996;28:813-19.

18. Ferrari A, Gregorini L, Ferrari MC, Preti L, Mancia G. “Digitalis and baroreceptor reflexes in man. Circulation. 1981;63:279-85.

19. Mahler F, Yoran C, Ross Jr. J, Inotropic effect of tachycardia and post stimulation potentation in conscious dog”. Am J Physiol. 1974;227:569-75.

20. Hasenfuss G, Holubarsch C, Herman HP, Pieske AB. y Just H. “Influence of the force-frecuency relationship on hemodinamics and left ventricular function in patients with non-failure hearts and in patients with dilated cardiomyopathy”. Eur Heart J. 1994;15:164-70.

21. Brogan WC, Hillis LD, Flores ED, Lange RA. “The natural history of isolated left ventricular diastolic dysfunction”. Am J Med. 1992;92:627-30.

22. Packer M., Lee WH, Kessler PD. ”Role of neurohormonal mechanism in determining survival in patients with severe chronic heart failure”. Circulation. 1987(Suppl. IV);75:80-92.

23. Benedict CR, Werner DH, Johnston DE, Bourasa M, Ghali GK. “Comparative neurohormonal responses in patients with preserved and in paired left ventricular ejection fraction: results of the studies of left ventricular dysfunction (SOLVD Registry)”. J Am Coll Cardiol. 1993;22(Suppl. A):146A-53A.

24. Senni M, Redfield M,. “Heart failure with preserved systolic function. A different natural history?”. J Am Coll Cardiol. 2001;38:1277-82.

25. Guadalajara JF. “¿Existe la insuficiencia cardiaca diastólica?”. Arch Cardiol Méx. 2003;73:291-300.

26. Kennedy JW, Baxley WA, Figley MM, Dodge HT, Blackmon JR. “Quantitative angiocardiography. 1. The normal left ventricle in man”. Circulation. 1966;34:272-8.

27. Dodge HT, Baxley WA. “Left Ventricular Volume and Mass and their significance in Heart Disease”. Am J Cardiol. 1969;23:528-36.

28. Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M, et al. “Localization and mechanism of secretion of B-Type natriuretic peptide in comparison with those of A-Type natriuretic peptide in normal subjets and patients with heart failure.” Circulation. 1994;90:195-203.

29. Maisel AS, McCord J, Nowak RM, Jollander JE, Wu AHB, Duc P, et al. “Bedside B-type natriuretic peptide in the emergency diagnosis of heart failure with reduced or preserved ejection fraction. Results from the Breathing not properly multinational study”. J Am Coll Cardiol. 2003;41:2010-17.

30. Borlaug BA, Redfield MM. “Diastolic and systolic heart failure are distinct phenotypes within the heart failure spectrum”. Circulation. 2011;123:2006-14.

31. Lee DS, Albano I, Larson MG, Benjamín EJ, Levi D, Kannel WB, et al. ”A systematic assessment of causes of death after heart failure onset in the community. Impact of age at death, time period, and left ventricular systolic dysfunction”. Circulation Heart Failure. 2011;4:36-43.

32. Gheorghiade M, Patel K, Filippatos NG, Anker SD, Van Veldhuisen DJ, Cleland JGF, et al. “Effect of oral digoxin in high-risk heart failure patients: a pre-specified subgroup analysis of the DIG trial”. Eur J Heart Fail. 2013;15:551-9.

33. Gheorghiade M, Braumwald E. ”Recopnsidering the role for digoxin in the management of acure Heart failure síndromes”. JAMA 2009;302:2146-7.

34. Packer M, Fowler MB, Roecker EB, Coats AJS, Katus HA, Krum H. “Effect of carvedilol on the morbidity of patients with severe chronic heart failure. Results of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) Study”. Circulation. 2002;106;2194-9.