Does digoxin therapy affect outcome in patients with diastolic heart failure?
Dirk L Brutsaert
Correspondence Middelheim Hospital, University of Antwerp, Lindendreef 1, 2020 Antwerp, Belgium
Email dirk.brutsaert@skynet.be
This article has no abstract so we have provided the first paragraph of the full text.
Over the past two decades, two distinct populations of patients with HF have been characterized, on the basis of an axiomatic binary subdivision of LVEF into normal (or preserved) LVEF and decreased LVEF. The cut-off point between the two groups has been arbitrarily set at an LVEF of 50%, although values have ranged from 40% to 55%, depending on the study. HF with normal ejection fraction, which is also referred to as diastolic HF, has been observed in nearly half of all patients with chronic HF. This condition is more commonly seen in older women, particularly those with a history of hypertension, left ventricular (LV) hypertrophy and, in some cases, diabetes mellitus. These patients are frequently hospitalized, and mortality is substantial. Nearly all large clinical trials of HF have excluded patients with diastolic HF; therapy is, therefore, empirical and has remained essentially the same as for other types of HF, i.e. prevention of risk factors and adverse LV remodeling.
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