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Digoxin withdrawal in patients with dilated cardiomyopathy following normalization of ejection fraction with beta

N W Shammas1, M L Harris, D McKinney

  • 1Genesis Heart Institute and Cardiovascular Medicine, PC, Davenport, Iowa 52803, USA. shammas@home.com

Clinical Cardiology
|January 5, 2002
PubMed

Insights

Digoxin withdrawal may slightly reduce left ventricular ejection fraction (LVEF) in idiopathic dilated cardiomyopathy patients on beta blockers. LVEF remained normal, but further trials are needed.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Idiopathic dilated cardiomyopathy (IDCM) management often involves beta blockers to normalize left ventricular ejection fraction (LVEF).
  • The impact of discontinuing digoxin in IDCM patients with normalized LVEF on beta blockers is not well understood.

Purpose of the Study:

  • To investigate the effect of digoxin withdrawal on left ventricular function in IDCM patients.
  • To assess changes in LVEF after discontinuing digoxin in patients previously stabilized with beta blockers.

Main Methods:

  • Eight IDCM patients with normalized LVEF on beta blockers underwent digoxin withdrawal.
  • Left ventricular ejection fraction (LVEF) was assessed using isotope ventriculography (IVG) before beta blocker initiation, after beta blocker treatment, and after digoxin withdrawal.

Main Results:

  • Mean baseline LVEF was 28.5%.
  • LVEF significantly improved to 56.1% with beta blockers.
  • After digoxin withdrawal, mean LVEF slightly decreased to 51.0% (p=0.05), remaining within the normal range.

Conclusions:

  • Digoxin withdrawal may cause a small, statistically significant reduction in LVEF in IDCM patients on beta blockers.
  • LVEF remained within normal limits (>50%) despite digoxin cessation.
  • Larger randomized trials are necessary to validate these preliminary findings.
Abstract

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