Özet:
This study aimed to evaluate the effectiveness
of digoxin in children with heart failure secondary to leftto-right
shunt lesions and normal left ventricular systolic
function. The study registered 37 such patients (ages
10 days to 24 months, groups 1 and 2) and used 20 healthy
children as a control group (group 3). Left ventricular
systolic function, as assessed by conventional echocardiography,
was normal in all the subjects. Congestive heart
failure was diagnosed by clinical evaluation and modified
Ross scoring. Plasma N-terminal prohormone of brain
natriuretic peptide (NT-proBNP) concentrations and complete
blood counts were assessed in all the children. Group
1 was treated with digoxin, enalapril, and furosemide and
group 2 with enalapril and furosemide. Approximately
1 month after starting treatment, the patients were reevaluated
by physical and echocardiographic examinations,
modified Ross scoring, plasma NT-proBNP concentrations,
and complete blood counts. The pre- and posttreatment
Ross scores of group 1 (p = 0.377) and group 2
(p = 0.616) did not differ significantly. The NT-proBNP
values in both groups decreased after treatment
(p = 0.0001). The pre- and posttreatment NT-proBNP
values did not differ significantly in group 1 (p = 0.094))
and group 2 (p = 0.372). The pretreatment NT-proBNP
values in groups 1 and 2 (p = 0.0001) were significantly
higher than in the control group (p = 0.003). A smaller
difference was observed between posttreatment NT-proBNP
values in group 1 and the control group (p = 0.045).
We found no significant difference between the posttreatment
NT-proBNP values of group 2 and those of the
control group (p = 0.271). The study showed that both
treatments currently used to treat heart failure secondary to
congenital heart disease with left-to-right shunts and preserved
left ventricular systolic function are effective and do
not differ significantly. Thus, digoxin does not provide any
extra benefit in the treatment of such patients.
