STROFANTINOVY TEST — the pharmacological test used for diagnosis of clinically latent heart failure, arrhythmias of heart and for definition of indications or contraindications to use of cardiac glycosides according to dynamics of functions of heart caused by introduction to the patient of strophanthin.
Patofiziol. S.'s basis of the item are features of action cardiac glycosides (see) on heart: on the one hand, they recover sokratitelny function of a myocardium and have antiarrhythmic effect if heart failure (see) and arrhythmia are caused by the dystrophy of a myocardium caused by hyperfunction (anti-dystrophic action); with another — their own aritmogenny action due to activation of the geterotopny centers of automatism of heart and oppression of conductivity affects.
At arrhythmias of heart (see) S. by the item it was used in two purposes: for detection of arrhythmia and diagnosis of its type (so-called provocative test with introduction of 0,125 mg of strophanthin) and for establishment of pathogenetic communication of the available arrhythmia with therapy by cardiac glycosides. Frequency of extrasystoles and conductivity change are estimated according to the ECG registered to and within 1 hour after intravenous administration strophanthin (see).
A. L. Syrkin (1975) suggested to analyze these monitorings of an ECG within 30 min. before jet introduction of 0,25 mg of strophanthin and within 1 hour after introduction. Negative reaction to single administration of strophanthin gives the grounds to assume bad portability of course treatment while the positive glikozidny test correlates with good results of the subsequent course treatment,
a Certain diagnostic value has S. of the item at establishment of the nature of arrhythmia at patients with suspicion of digitalis intoxication (see the Foxglove) when it is unknown whether the patient received cardiac glycosides and in what doses. In these cases M. E. Slutsky (1966) recommends to use for test instead of strophanthin Korglykonum which works quicker and eliminirut from an organism. Korglykonum is entered to the patient intravenously kapelno at continuous registration of an ECG. Increase of extrasystoles indicates high probability of digitalis intoxication, their urezheniye testifies to indications to use of cardiac glycosides. Reliability of the diagnosis of digitalis intoxication significantly increases if arrhythmia is eliminated in the course of additional test with introduction to the patient of disodium salt etilendiamintetrauksusiy to - you (3 — 4 g in 250 ml of 5% of solution of glucose) or 2% of solution of sodium citrate (50 — 250 ml). It is desirable to carry out the last test to test with Korglykonum.
For diagnosis of the latent heart failure and its communication with dystrophy of a myocardium as a result of hyperfunction (see. Myocardial dystrophy ) Villages of the item carry out a wedge with assessment, given about a condition of blood circulation. Across Hegglin (R. Heg-glin, 1961), S. the item assumes measurement of a diuresis and pulse rate before introduction of sick 0,25 mg of strophanthin. B. E. Votchal recommended weighing of patients, the Crimea was poured by 0,25 mg of strophanthin (without diuretics against the background of a standard diet) within 2 days; at loss more than 1,5 kg of weight test is considered positive. In modern clinics S.'s results of the item can be objektivizirovana registration of various parameters of cordial activity. F. I. Komarov and A. A. Olbinskaya (1978) carried out this test in the conditions of rest and in the conditions of the dosed exercise stress, registering a complex of parameters of a cardiohemodynamics to and in 30 min. after intravenous administration of strophanthin in a dose of 0,0036 mg/kg. As page of the item was considered positive if reliable improvement or normalization of initially changed parameters of a cardiohemodynamics in the conditions of rest was noted, at an exercise stress of the submaximum power, and also if tolerance to an exercise stress increased or the period of recovery extended earlier decreased.
Bibliography: Votchal B. E. and Slutsk M. E. Cardiac glycosides, M., 1973; F. I. Mosquitoes and About l and nanosecond to and I am JI. I. Initial stage of heart failure, page 225, M., 1978; With t r and ~ e with to about N. D. Strofantin as cardiac, Kiev, 1910; With y r to both N A. L. and Pecherskaya M. B. Antiarrhytmic effect of cardiac glycosides at chronic coronary heart disease, Cardiology, t. 15, No. 7, page 67, 1975; X e of of l and N of River. Differential diagnosis of internal diseases, the lane with it., M., 1965.
S. M. Kamenker.