Evidence supporting the use of: Digitalis
For the health condition: Congestive Heart Failure

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Digitalis, derived primarily from the plant Digitalis purpurea (foxglove), has a well-established scientific basis for use in the treatment of congestive heart failure (CHF). The principal active compounds, known as cardiac glycosides (notably digoxin and digitoxin), exert their therapeutic effect by inhibiting the sodium-potassium ATPase pump in cardiac tissue. This inhibition leads to an increase in intracellular sodium, which in turn promotes increased intracellular calcium via the sodium-calcium exchanger. The result is enhanced myocardial contractility (positive inotropy), which helps the failing heart pump more effectively.

The evidence supporting the use of digitalis in CHF is robust, originating from both historical clinical experience and controlled clinical trials. The use of digitalis dates back to the late 18th century, when William Withering first documented its efficacy in treating "dropsy" (edema caused by heart failure). In the modern era, large randomized controlled trials, such as the Digitalis Investigation Group (DIG) trial, have demonstrated that while digoxin does not reduce mortality in CHF patients, it does reduce hospitalizations and improves symptoms, especially in patients with systolic dysfunction and atrial fibrillation. However, its narrow therapeutic index and risk of toxicity have led to more selective use in contemporary practice, often as an adjunct to other heart failure therapies.

In summary, digitalis is scientifically validated as a supportive therapy in CHF, particularly for symptom control and reducing hospitalizations, though it is no longer considered a first-line agent due to safety concerns and the availability of more effective medications.

More about Digitalis
More about Congestive Heart Failure

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