The normal function of the heart, continuous contraction-relaxation, is maintained on the basis of a chain of biochemical reactions in the myocardium. A disturbance somewhere in this metabolic process leads to the functional disturbance of the heart.
Although the fact that digitalis therapy is the most typical and most effective treatment of heart failure has been remained unchanged since the old time of Withering, the consideration on myocardial metabolism would make the effect of digitalis more certain and more pronounced. The treatment aiming at the improvement of myocardial metabolism has recently been introduced in clinical practice.
In the present paper, in order to understand the significance of metabolic therapy in the treatment of heart failure, the myocardial metabolism under various pathological conditions was observed, and the effects of so-called metabolic remedies were investigated experimentally and clinically. Furthermore, the future of metabolic therapy will be inferred.
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