[Features of the treatment of heart failure in the elderly].

PHARMACOLOGICAL MODIFICATIONS TO BE TAKEN INTO ACCOUNT: In elderly patients, there is a modification in the distribution columns of drugs, an alteration in glomerular filtration (doses require adaptation) and tubular function (greater sensitivity to low salt diet and diuretics), and a reduction in the hepatic elimination capacity. FOR SYSTOLIC HEART FAILURE: The choice of drugs is in practice the same as that for younger patients: diuretics, antialdosterone agents, converting enzyme inhibitors, angiotensin II receptor antagonists, beta-blockers and digitalics. FOR DIASTOLIC HEART FAILURE: The therapeutic approach combines an etiologic treatment (blood pressure, myocardial ischaemia), prevention and the rapid treatment of the decompensation factors (atrial arrhythmia), a pharmacological treatment (converting enzyme inhibitors, angiotensin II receptor antagonists, and bradycardia lowering agents).

[Informed consent, what information is left after a therapeutic trial?].

In order to evaluate the outcome of information given to patients included in a therapeutic trial after having signed a consent form, 77 patients (68 men, 9 women with an average age of 57.9 years) included in the IMPACT study (multicenter, randomised, double-blind protocol, the main objective of which was to assess the antiarrhythmic effect of oral administration of delayed action mexiletine in patients with a recent myocardial infarction), answered a questionnaire of 85 items. The quantity and degree of comprehension of the recalled information at the end of the trial were appreciated from the replies to 13 questions based on the definition or understanding of the most important details of the consent form and on a comprehension score with a maximum value of 14 points.

[Diltiazem and digoxin interaction. Development of digoxin plasma levels and electrocardiographic parameters in healthy subjects].

In order to determine the interaction between diltiazem and digoxin, plasma digoxin concentrations and the principal ECG parameters (24 hour Holter monitoring) were measured in 10 healthy volunteers under basal conditions (P0), with 0.375 mg/day of digoxin (P1 = 17 days), during association with 240 mg/day of diltiazem (P2 = 17 days) and then again on digoxin alone (P3 = 10 days). The addition of diltiazem was associated with a 20.