Pharmacokinetic evaluations with highly sophisticated analytical methods.

26 patients, aged between 53 and 72 years, with chronic myocardial insufficiency of different degrees, proved radiologically by an enlargement of the heart and a mean reduction of left ventricular ejection fraction by more than 50%, were subjected to 4 weeks of treatment with 3 x 60 drops/day Miroton, (Chemische) Werke Minden GmbH), a cardioactive glycoside mixture, following a washout phase of 4 weeks. The effect on end-diastolic volume (EDV) and left ventricular ejection fraction (LVEF) was recorded and calculated by ECG-triggered radionuclide angiography both before, and after 2 and 4 weeks of medication with Miroton. On therapy with Miroton the EDV decreased by 4% after 14 days and by 18% after 4 weeks (compared to the baseline value of 126.8 ml). In contrast to this, the LVEF increased to 47.2% after 14 days and to 56% after 4 weeks (baseline value 43.7%). The inverse relation between EDV and LVEF shows a positive inotropic influence on the myocardium which was more pronounced in the last 2 weeks of treatment than in the first 2 weeks.