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Long-term digitalis therapy improves left ventricular function in heart failure.

S B Arnold, R C Byrd, W Meister

    The New England Journal of Medicine
    |December 18, 1980
    PubMed
    Summary
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    Long-term oral digoxin therapy improves hemodynamics in patients with symptomatic heart failure. Stopping digoxin worsened heart function, while readministration restored benefits, confirming its value.

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Digoxin is a common treatment for heart failure.
    • The benefits of long-term oral digoxin therapy remain debated.

    Purpose of the Study:

    • To evaluate the hemodynamic effects of long-term oral digoxin in patients with symptomatic heart failure.

    Main Methods:

    • Nine patients in sinus rhythm with heart failure were studied.
    • Hemodynamics were assessed at rest and during exercise during long-term digoxin therapy, after drug withdrawal, and after readministration.

    Main Results:

    • Digoxin withdrawal led to increased pulmonary capillary-wedge pressure and decreased cardiac index, indicating worsened left ventricular function.
    • Stroke-work index, stroke-volume index, and ejection fraction also decreased upon digoxin withdrawal.

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  • Acute readministration of digoxin restored hemodynamic values, with similar improvements observed during exercise.

    • Conclusions:

    • Long-term oral digoxin therapy provides significant hemodynamic benefits in patients with symptomatic heart failure.
    • Withdrawal of digoxin results in deterioration of cardiac function.
    • Digoxin therapy is valuable for managing congestive heart failure.