What is the expected clinical benefit of digoxin in a patient with heart failure with preserved ejection fraction (HFpEF)?

In heart failure with preserved ejection fraction (HFpEF), the role of digoxin is not well-established, and current guidelines do not support its use for providing significant clinical benefit in this patient population. Unlike in heart failure with reduced ejection fraction (HFrEF), where digoxin can offer advantages such as improved symptoms and reduced hospitalizations, the evidence supporting digoxin's effectiveness in HFpEF is lacking.

Clinical studies have demonstrated that digoxin does not improve mortality rates or significantly reduce the risk of hospitalization related to heart failure in patients with preserved ejection fraction. Consequently, the treatment guidelines highlight that there is essentially no meaningful clinical benefit from the use of digoxin in HFpEF, making it an inappropriate choice for managing this condition. As such, the expected outcome is no clinical benefit in this specific context.