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Effect of digoxin on left ventricular contractility in newborns and infants estimated by echocardiography
Insights
This study found that low doses of digoxin significantly improve left ventricular contractility in newborns. Echocardiography confirmed increased shortening fraction and mean velocity of fiber shortening, showing a positive inotropic effect.
Area of Science:
- Neonatal Cardiology
- Pediatric Pharmacology
- Cardiac Physiology
Background:
- Newborns are susceptible to digoxin toxicity.
- Understanding digoxin's effects on infant cardiac function is crucial.
Purpose of the Study:
- To evaluate the impact of low-dose digoxin on left ventricular contractility in newborns.
- To assess digoxin's positive inotropic effects in this population.
Main Methods:
- Echocardiography was used to measure left ventricular ejection time, end-diastolic diameter, and end-systolic diameter.
- Measurements were taken before and after initial or full digoxin digitalization.
- Shortening fraction (SF) and mean velocity of fiber shortening (mean Vcf) were calculated.
Main Results:
- Both SF and mean Vcf showed significant increases after the first digoxin dose and full digitalization.
- The observed improvements in contractility were consistent between newborns and infants.
- Mean plasma digoxin concentration after full digitalization was 2.2 ng/ml.
Conclusions:
- Low-dose digoxin demonstrates a clear positive inotropic effect in newborns.
- Digoxin can safely enhance cardiac contractility in infants.
- This supports the use of digoxin in neonatal cardiac care.
Abstract:
In view of the known susceptibility of newborns to digoxin intoxication this study was undertaken in order to evaluate the effect of a relatively low digoxin dose on left ventricular contractility of newborn infants. Left ventricular ejection time, enddiastolic diameter and endsystolic diameter were measured by echocardiography before digitalization as well as between 2 and 4 h after the first digoxin dose (group 1 : 16 patients) or after full digitalization (group 2 : 12 patients). From these data, shortening fraction (SF) and mean velocity of fiber shortening (mean Vcf) were calculated. We found that SF and mean Vcf increased significantly in both groups after the first digoxin dose and after full digitalization. The increase was equal in newborns and infants. The mean plasma digoxin concentration after full digitalization was 2.2 ng/ml (range 0.7--4.4 ng/ml). These results demonstrate clearly the positive inotropic effect of a relatively low digoxin dose in newborns.