The Effect of Digoxin and Verapamil on Heart Rate, Pulmonary Artery and Pulmonary Wedge Pressure in Patients with Pure Mitral Stenosis

The effect of verapamil and digoxin on heart rate, mean pulmonary artery pressure and pulmonary wedge pressure was investigated in patients with pure mitral stenosis. Both groups consisted of 15 patients (6 atrial fibrillation, 9 sinus rhythm in the digoxin group; 8 atrial fibrillation, 7 sinus rhythm in the verapamil group). Heart rate, pulmonary artery pressure and pulmonary wedge pressure were remeasured after intravenous administration and 7 days of oral treatment. In patients with sinus rhythm there was no significant change in mean pulmonary artery pressure, pulmonary wedge pressure and heart rate after digoxin treatment (p>0.05). Although, there was no significant decrease in heart rate with verapamil treatment in patients with sinus rhythm (p>0.05), mean pulmonary artery pressure decreased significantly (p<0.05). In this group pulmonary wedge pressure did not show any significant decrease after intravenous verapamil therapy, but it declined remarkably after 7 days of oral therapy (p<0.05). Although digoxin caused significant reduction in heart rate in patients with atrial fibrillation (p<0.05), the decreases in mean pulmonary artery pressure and pulmonary wedge pressure were not significant. The heart rate diminished with verapamil in patients with atrial fibrillation (p<0.01). In this group, pulmonary artery pressure and pulmonary wedge pressure showed a significant decrease, to. Our study shows that verapamil is more effective than digoxin for reducing heart rate, mean pulmonary artery pressure and pulmonary wedge pressure in patients with pure mitral stenosis who are either in sinus rhythym or in atrial fibrillation.