Cardiac Glycosides 1785–1985

1. Front Matter

   Pages I-XVII

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2. Historial aspects

   1. William Withering — The man and his work

      • J. C. Skou

      Pages 1-10

   2. Fruitful routes and blind alleys taken by digitalis therapy since its introduction by Withering

      • Hans Schadewaldt

      Pages 11-16

   3. Therapeutic use of digitalis until the time of William Withering

      • L. M. Jung

      Pages 17-18

3. Cardiac glycosides, (Na+ + K+)-ATPase and cation transport

   1. The function of Na+,K+-ATPase and its importance for drug action

      • T. Akera

      Pages 19-25

   2. Structural studies on the cardiac glycoside receptor

      • E. T. Wallick, T. L. Kirley, A. Schwartz

      Pages 27-33

   3. Isoenzymes of Na,K-ATPase identified by pyrithiamin

      • Otto Hansen

      Pages 35-40

   4. Interaction of cardiac glycosides with Na/K-ATPase in intact myocardium

      • S. Herzig, H. Lüllmann, K. Mohr

      Pages 41-47

   5. The human red blood cell: A model for ouabain receptor regulation in the heart?

      • Lindsay Brown, K. Werdan, E. Erdmann

      Pages 49-54

   6. Binding and release of ouabain at low Mg2+ in reconstituted human red blood cell ghosts

      • H. H. Bodemann

      Pages 55-59

   7. The ouabain receptor in the myocardium and conduction system of the sheep heart

      • E. Hug, L. Brown, Erland Erdmann

      Pages 61-68

   8. Electrophysiological effects of cardiac glycosides

      • D. A. Eisner, M. Valdeolmillos, W. J. Lederer, M. B. Cannell

      Pages 69-78

   9. Electrophysiological assay of glycoside-induced sodium pump inhibition in isolated sheep heart Purkinje fibres at the onset of toxicity

      • C. Achenbach, Han Daying, R. Preisler

      Pages 79-86

   10. Rat cardiac hypertrophy: contribution of heteregeneous digitalis receptor forms

       • L. G. Lelièvre, J. M. Maixent, D. Charlemagne, B. Swynghedauw

       Pages 87-92

   11. Digitalis receptors in normal and hypertrophied rat hearts. Differential effects of a Ca2+ free perfusion

       • D. Charlemagne, E. Mayoux, M. Preteseille, J. M. Maixent, Ch. Mouas, B. Swynghedauw et al.

       Pages 93-98

   12. Biphasic contractile response to ouabain: Species specific? Calcium dependent? Altered sensitivity?

       • G. Grupp, Ingrid L. Grupp, T. Hickerson, S. W. Lee, A. Schwartz

       Pages 99-108

   13. The influence of α-tocopherol-nicotinate (Renascin^®) on cardiac glycoside effects

       • H. Tawfik, P. Schlieper

       Pages 109-117

   14. On the connection between cardiac glycosides and calcium action

       • H. Waginger, D. S. Regal

       Pages 119-125

   15. Biochemical basis for the targeted synthesis of cardiac glycosides with selective action

       • W. Schönfeld, J. Weiland, K. R. H. Repke

       Pages 127-134

4. Digitalis-like substances

   1. The “endogenous cardiac glycoside”

      • W. Schoner, K. Moreth, R. Kuske, D. Renner

      Pages 135-142

The bicentenary of William Withering's now famous medical report entitled "An Account of the Foxglove and Some of its Medical Uses" has given us the occasion to analyze the state of the art. Cardiac glycosides in 1985 are considered tobe the basis for medical treatment of myocardial failure, together with diuretics and vasodilators in the more severe cases. Nevertheless, the controversy as to their exact place in the treatment of heart failure with sinus rhythm has never ceased. Although cardiac glycosides are of unquestionable value in tachycardia caused by atrial fibrillation or atrial flutter, the chronic use of these drugs in sinus rhythm is not generally accepted. The development of tolerance has been reported. It is of interest that Withering hirnself wrote: "-let it (foxglove) be continued until it either acts on the kidneys, the stomach, the pulse, or the bowels; Iet it be stopped upon the first appearance of any of these effects, and I will maintain that the patient will not suffer from its exhibition, nor the practitioner be disappointed in any reasonable expectation. " In West Germany alone, more than three million patients (about 5% of the total population) are constantly taking cardiac glycosides. These drugs are the most prescribed medicaments in many countries. Thus, we considered it worthwhile and necessary to review in a critical way today's knowledge about the foxglove; to report new findings and to evaluate old Statements.

• anesthesia
• artery
• atrial fibrillation
• drugs
• electrocardiogram (ECG)
• heart
• heart disease
• heart failure
• myocardial infarction
• pharmacodynamics
• physiology

• Medizinische Klinik I, Klinikum Großhadern der Universität München, München 70, West Germany

  Erland Erdmann

• Institut für Pharmakologie, Universität Düsseldorf, Düsseldorf, West Germany

  K. Greef

• Biophysik Institut, Aarhus Universitet, Aarhus, Denmark

  J. C. Skou

Policies and ethics