Wissam Alajaji1, Atallah Baydoun2, Sadeer G Al-Kindi3, Leslie Henry4, Mazen A Hanna5, Guilherme H Oliveira6. 1. Summa Cardiovascular Institute, Summa Health System, Akron, OH, United States. 2. Louis Stokes VA Medical Center, Cleveland, OH, United States; Case Western Reserve University School of Medicine, Cleveland, OH, United States. 3. Department of Medicine, University Hospitals Case Medical Center, Cleveland, OH, United States; Case Western Reserve University School of Medicine, Cleveland, OH, United States. 4. University Hospitals Case Medical Center Core Library, Cleveland, OH, United States. 5. Division of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States. 6. Case Western Reserve University School of Medicine, Cleveland, OH, United States; Division of Cardiovascular Medicine, Heart and Vascular Institute, University Hospitals Case Medical Center, Cleveland, OH, United States. Electronic address: guilherme.oliveira@uhhospitals.org.
Abstract
OBJECTIVE: Right heart failure is associated with increased mortality and morbidity. The optimal treatment for patients with RV failure is not established. The aim of this study is to conduct a systematic review of the literature to assess the relative benefits and harms of digoxin therapy in patients with RV failure. METHODS: We performed a literature search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) on Nov. 4, 2014. We did not use publication type, period or language restrictions to the search strategy. Exclusions included: trials that excluded patients with RV failure, included patients requiring mechanical or intravenous inotropic support, review papers and case reports. The primary outcome was long-term efficacy outcomes of digoxin in right heart failure. Two reviewers screened titles and abstracts of identified citations independently and in duplication using calibration exercises and standardized screening forms. RESULTS: The search strategy identified 4097 citations, and 4 studies were included in this analysis (n=76 patients). Of the four studies, two assessed improvements in RVEF, two studies compared exercise capacity indexes, and one assessed symptoms with digoxin compared with placebo. No study assessed mortality outcomes. Overall, there was no statistically significant improvement in RVEF, exercise capacity, NYHA class, heart failure score, or body weight. CONCLUSIONS: There are few studies evaluating Digitalis use for RV failure, which are limited to patients with cor pulmonale. In these patients, Digitalis use provides no improvement in RVEF, exercise capacity, or NYHA class. Randomized clinical trials are needed to address this question.
OBJECTIVE:Right heart failure is associated with increased mortality and morbidity. The optimal treatment for patients with RV failure is not established. The aim of this study is to conduct a systematic review of the literature to assess the relative benefits and harms of digoxin therapy in patients with RV failure. METHODS: We performed a literature search in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) on Nov. 4, 2014. We did not use publication type, period or language restrictions to the search strategy. Exclusions included: trials that excluded patients with RV failure, included patients requiring mechanical or intravenous inotropic support, review papers and case reports. The primary outcome was long-term efficacy outcomes of digoxin in right heart failure. Two reviewers screened titles and abstracts of identified citations independently and in duplication using calibration exercises and standardized screening forms. RESULTS: The search strategy identified 4097 citations, and 4 studies were included in this analysis (n=76 patients). Of the four studies, two assessed improvements in RVEF, two studies compared exercise capacity indexes, and one assessed symptoms with digoxin compared with placebo. No study assessed mortality outcomes. Overall, there was no statistically significant improvement in RVEF, exercise capacity, NYHA class, heart failure score, or body weight. CONCLUSIONS: There are few studies evaluating Digitalis use for RV failure, which are limited to patients with cor pulmonale. In these patients, Digitalis use provides no improvement in RVEF, exercise capacity, or NYHA class. Randomized clinical trials are needed to address this question.
Authors: S Ashwin Reddy; Sarah L Nethercott; Bharat V Khialani; Andrew A Grace; Claire A Martin Journal: J Interv Card Electrophysiol Date: 2021-04-05 Impact factor: 1.900
Authors: Hui Huang; Kuizhong Shan; Min Cai; Hong Chen; Fengmei Wu; Xiaoyan Zhao; Huawei Zhuang; Hong Li; Suofang Shi Journal: Evid Based Complement Alternat Med Date: 2021-10-26 Impact factor: 2.629