Key result
Low-dose digoxin (0.125 mg daily) increased left ventricular ejection fraction from 22% to 42% and improved heart failure symptoms in a patient with anthracycline-induced cardiomyopathy.
Why the study?
Anthracyclines cause cardiotoxic side effects, and cardioprotective drugs are recommended for anthracycline-induced cardiomyopathy, but managing persistent heart failure remains challenging.
Does digoxin improve LVEF and heart failure symptoms in a patient with anthracycline-induced cardiomyopathy refractory to standard cardioprotective therapy?
Case Report (n=1)
Does digoxin improve LVEF and heart failure symptoms in a patient with anthracycline-induced cardiomyopathy refractory to standard cardioprotective therapy?
Absolute Event Rate: 42% vs 22%
Low-dose digoxin may be an effective and safe option for improving LVEF and symptoms in patients with anthracycline-induced cardiomyopathy who are refractory to standard cardioprotective therapy.
May support digoxin trial in refractory anthracycline cardiomyopathy; hypothesis-generating and leaves open need for controlled studies.
Anthracyclines have cardiotoxic side effects. Cardioprotective drugs such as angiotensin-converting enzyme inhibitors and beta-blockers are therefore recommended for patients with anthracycline-induced cardiomyopathy. We herein present a 54-year-old woman with recurrent metastatic breast cancer who developed heart failure (HF) with a left ventricular ejection fraction (LVEF) of 22% after undergoing epirubicin chemotherapy. However, her HF symptoms and low LVEF persisted despite 5 months of cardioprotective therapy and additional oral pimobendan. Pimobendan was discontinued because of ventricular arrhythmia and hypotension. After the start of low-dose (0.125 mg daily) digoxin, her LVEF increased to 42%, and her HF symptoms improved with no adverse events.
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Shiga et al. (2021) conducted a case report in Anthracycline-induced cardiomyopathy and metastatic breast cancer (n=1). Digoxin was evaluated on Left ventricular ejection fraction (LVEF). Low-dose digoxin (0.125 mg daily) increased left ventricular ejection fraction from 22% to 42% and improved heart failure symptoms in a patient with anthracycline-induced cardiomyopathy.
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