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Association Between Digoxin Use and Cardiac Function in Infants With Single-Ventricle Congenital Heart Disease During the Interstage Period.

Publication ,  Journal Article
Kumar, KR; Flair, A; Thompson, EJ; Zimmerman, KO; Andersen, ND; Hill, KD; Hornik, CP
Published in: Pediatr Crit Care Med
June 1, 2022

OBJECTIVES: To examine the association between digoxin use and cardiac function assessed by echocardiographic indices in infants with single-ventricle (SV) congenital heart disease (CHD) during the interstage period. DESIGN: Retrospective cohort study. SETTING: Fifteen North American hospitals. PATIENTS: Infants discharged home following stage 1 palliation (S1P) and prior to stage 2 palliation (S2P). Infants with no post-S1P and pre-S2P echocardiograms were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 373 eligible infants who met inclusion criteria, 140 (37.5%) were discharged home on digoxin. In multivariable linear and logistic regressions, we found that compared with infants discharged home without digoxin, those discharged with digoxin had a smaller increase in end-systolic volume (β = -8.17 [95% CI, -15.59 to -0.74]; p = 0.03) and area (β = -1.27 [-2.45 to -0.09]; p = 0.04), as well as a smaller decrease in ejection fraction (β = 3.38 [0.47-6.29]; p = 0.02) and fractional area change (β = 2.27 [0.14-4.41]; p = 0.04) during the interstage period. CONCLUSIONS: Digoxin may partially mitigate the expected decrease in cardiac function during the interstage period through its positive inotropic effects. Prospective clinical trials are needed to establish the pharmacokinetics, safety, and efficacy of digoxin use in SV CHD.

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Published In

Pediatr Crit Care Med

DOI

ISSN

1529-7535

Publication Date

June 1, 2022

Volume

23

Issue

6

Start / End Page

453 / 463

Location

United States

Related Subject Headings

  • Univentricular Heart
  • Treatment Outcome
  • Retrospective Studies
  • Prospective Studies
  • Pediatrics
  • Palliative Care
  • Norwood Procedures
  • Infant
  • Hypoplastic Left Heart Syndrome
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Kumar, K. R., Flair, A., Thompson, E. J., Zimmerman, K. O., Andersen, N. D., Hill, K. D., & Hornik, C. P. (2022). Association Between Digoxin Use and Cardiac Function in Infants With Single-Ventricle Congenital Heart Disease During the Interstage Period. Pediatr Crit Care Med, 23(6), 453–463. https://doi.org/10.1097/PCC.0000000000002946
Kumar, Karan R., Antonina Flair, Elizabeth J. Thompson, Kanecia O. Zimmerman, Nicholas D. Andersen, Kevin D. Hill, and Christoph P. Hornik. “Association Between Digoxin Use and Cardiac Function in Infants With Single-Ventricle Congenital Heart Disease During the Interstage Period.Pediatr Crit Care Med 23, no. 6 (June 1, 2022): 453–63. https://doi.org/10.1097/PCC.0000000000002946.
Kumar KR, Flair A, Thompson EJ, Zimmerman KO, Andersen ND, Hill KD, et al. Association Between Digoxin Use and Cardiac Function in Infants With Single-Ventricle Congenital Heart Disease During the Interstage Period. Pediatr Crit Care Med. 2022 Jun 1;23(6):453–63.
Kumar, Karan R., et al. “Association Between Digoxin Use and Cardiac Function in Infants With Single-Ventricle Congenital Heart Disease During the Interstage Period.Pediatr Crit Care Med, vol. 23, no. 6, June 2022, pp. 453–63. Pubmed, doi:10.1097/PCC.0000000000002946.
Kumar KR, Flair A, Thompson EJ, Zimmerman KO, Andersen ND, Hill KD, Hornik CP. Association Between Digoxin Use and Cardiac Function in Infants With Single-Ventricle Congenital Heart Disease During the Interstage Period. Pediatr Crit Care Med. 2022 Jun 1;23(6):453–463.

Published In

Pediatr Crit Care Med

DOI

ISSN

1529-7535

Publication Date

June 1, 2022

Volume

23

Issue

6

Start / End Page

453 / 463

Location

United States

Related Subject Headings

  • Univentricular Heart
  • Treatment Outcome
  • Retrospective Studies
  • Prospective Studies
  • Pediatrics
  • Palliative Care
  • Norwood Procedures
  • Infant
  • Hypoplastic Left Heart Syndrome
  • Humans