PMID: 9449960Feb 5, 1998Paper

Heart failure in patients with preserved left ventricular systolic function: do digitalis glycosides have a role?

Progress in Cardiovascular Diseases
Barry M Massie, I Abdalla

Abstract

It is being increasingly appreciated that a substantial number of patients with congestive heart failure (CHF) have relatively preserved systolic function. Although these individuals appear to have a somewhat better prognosis than those with low ejection fractions, they experience significant symptoms and frequently require hospitalization. In these patients, CHF is often attributed to left ventricular diastolic dysfunction, but this represents a potentially misleading over-simplification. In contrast to CHF associated with left ventricular systolic dysfunction, little is known about how to treat patients with preserved systolic function. Perhaps the major point of consensus has been that the use of digitalis glycosides is inappropriate in this group. Unexpectedly, however, in the recently completed Digitalis Investigators Group trial, a subgroup of nearly 1,000 patients with radionuclide ejection fractions > or = 45% experienced a similar reduction in heart failure endpoints with digoxin therapy as patients with 25% to 44% ejection fractions. The purpose of this article is to review the diverse causes of CHF with preserved systolic function and to examine the potential mechanisms by which digoxin may be producing beneficial ef...Continue Reading

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Citations

Aug 29, 2006·Heart Failure Reviews·Karen Hogg, John McMurray
Nov 26, 2008·Current Treatment Options in Cardiovascular Medicine·Anita Deswal, Biykem Bozkurt
Jun 5, 2012·Current Treatment Options in Cardiovascular Medicine·Samuel Bernard, Mathew S Maurer
May 4, 2001·The American Journal of Medicine·K F Adams
Jun 12, 2003·Journal of the American College of Cardiology·Barry M Massie
Jan 25, 2007·Nature Clinical Practice. Cardiovascular Medicine·Dirk L Brutsaert
Jan 31, 2002·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Ali AhmedJames F DeLong
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Apr 3, 2008·Current Opinion in Cardiology·Aparajita DasAnita Deswal
Oct 9, 2007·Current Opinion in Cardiology·Akshay Desai

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