[Role of digitalis derivatives in the treatment of cardiac insufficiency with sinusal rhythm].

The value of digitalis in the treatment of heart failure with sinus rhythm remains controversial. It has been demonstrated that the moderate positively inotropic effect of digitalis observed after acute administration persists without tachyphylaxis. Digitalis produces symptomatic improvement, but its therapeutic quotient is low and its influence on mortality is unknown. This last point has become crucial, especially since some positively inotropic drugs increase ventricular rhythm disorders and are responsible for over-mortality among heart failure patients. In contrast, angiotensin-converting enzyme inhibitors reduce mortality in patients with severe heart failure. In short, digitalis is useful only in certain physiopathological types of heart failure where it is used electively and complements the action of angiotensin-converting enzyme inhibitors.