Digoxin Versus Ivabradine in Heart Failure With Preserved Systolic Function (DIGvsIVA)
Comparison of Digoxin and Ivabradine in Heart Failure With Preserved Systolic Function.
This is an investigator-started study. The trial is coded as no. GC&PJ-Dig-Iva2009-2012.
The authors have no conflict of interest and there was no financial sponsoring The study was planned according to the Good Clinical Quality standards using an intention-to-treat analysis. The protocol was approved from the ethics committee. Selected patients gave their written informed consent. The family practitioners agreed and obtained the collected data and analysis. Analysis of collected data was performed by a single-blinded author (without knowledge of the used test drug and time of collection of data).
Study Hypothesis: Compare the effect of digoxin and ivabradine in chronic heart failure with permanent atrial fibrillation (ischemic etiology).
Multiple Time Frames: Primary Outcome is measured before and after each medical intervention.
Measurements at baseline and after 3 month of therapy (twice, with the 2 different drugs):
Measurements Severity of dyspnea. Digoxin serum concentration. ECG: Heart rate at rest and during 6-min walking test. Cardiac function (echocardiography): systolic function (ejection rate, left trial size,diastolic function.
Participants were followed (ambulatory observation) for at least 3 months
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Selected patients had chronic coronary artery disease which had been treated with percutaneous dilatation & stenting and/or aortocoronary bypass. The severity of myocardial ischemia had induced heart failure with diastolic dysfunction and preserved systolic function, and permanent AF.
1 Inclusion criteria:
Dyspnea class III NYHA.
Abnormal left ventricular relaxation with preserved (≥52%) ejection fraction (LVEF).
Patients either in sinus rhythm or with permanent atrial fibrillation.
2. Exclusion criteria:
Unstable angina pectoris.
Reduced systolic cardiac function (LVEF<52%).
Normal diastolic function.
Diabetes requiring insulin.
Moderate or severe renal or hepatic dysfunction.
Technically insufficient echocardiography.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
Argovia
-
Rheinfelden, Argovia, Switzerland, CH-4310
- Cardiology office
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
No need to change concomitant pharmacological therapy in the following months, dyspnea class III NYHA, and abnormal left ventricular relaxation with preserved (≥52%) left ventricular ejection fraction (LVEF).
Exclusion Criteria:
Unstable myocardial ischemia, reduced systolic cardiac function (LVEF<52%), diabetes mellitus requiring insulin, moderate or severe renal or hepatic dysfunction, or technically insufficient echocardiography.
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Crossover
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Digoxin cross-over ivabradine
Digoxin 0,125 mg once a day 5 days per week during 3 months.
Ivabradine, 7,5 mg b.id.
during 3 months.
|
No more details
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cardiac function (diastolic and systolic function)
Time Frame: After 12-14 weeks
|
Cardiac function (echocardiography): systolic function (i.e.
LVEF) and diastolic function (Doppler E/A ratio, tissue Doppler e/e1 ratio, Doppler deceleration time of the E wave.
|
After 12-14 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Heart rate and blood pressure.
Time Frame: After 12-14 weeks
|
Changes in heart rate and blood pressure.
|
After 12-14 weeks
|
|
Dyspnea.
Time Frame: After 12-14.weeks
|
Changes in dyspnea NYHA class).
|
After 12-14.weeks
|
|
NB-proBNP value
Time Frame: After 12-14 weeks
|
Changes (serum values) after therapy.
|
After 12-14 weeks
|
|
Body weight
Time Frame: 12-14. weeks
|
Changes after therapy
|
12-14. weeks
|
|
Left atrial size
Time Frame: After 12-14 weeks
|
Change (size).
|
After 12-14 weeks
|
|
ECG
Time Frame: After 12-14 weeks
|
Changes (heart rate,PR-interval, QRS morphology and duration), ST-T segment, other arrhythmias
|
After 12-14 weeks
|
|
Laboratory
Time Frame: After 12-14 weeks
|
Any changes in hematology, electrolytes, renal and hepatic function.
|
After 12-14 weeks
|
|
Side-effects
Time Frame: After 12-14 weeks
|
Any side-effects, spontaneously reported or after specific questionining.
|
After 12-14 weeks
|
|
6-min walk test
Time Frame: After 12-14 weeks.
|
Changes in length of the walk test and heart rate during the test.
|
After 12-14 weeks.
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Giuseppe Cocco, MD, Cardiologist, senior lecturer
Publications and helpful links
General Publications
- Cocco G, Jerie P. Comparison of digoxin and ivabradine in heart failure with preserved systolic function. Submitted to the American Heart Journal.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- GC&PJ-Dig-Iva-2009-2012
- Cocco G, M.D. (Other Grant/Funding Number: Cocco G, MD)
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