Original ArticlesCarvedilol as therapy in pediatric heart failure: An initial multicenter experience☆
Section snippets
Patients and Dosing
Investigators from 6 medical centers were asked to review the medical records of pediatric patients with heart failure, age 0 to 19 years, who received carvedilol in addition to standard therapy of digoxin, diuretics, and ACE inhibitors. Underlying diagnoses, morphologic ventricle types (left ventricle or right ventricle), details of the standard heart failure therapy (initial doses and any changes of digoxin, diuretics, ACE inhibitors, or other vasodilator therapy), and details of carvedilol
Patient Population and Diagnoses
Children from 6 medical centers, ranging in age from 3 months to 19 years (n = 46), were treated with carvedilol from January 1998 through February 2000 (Table II).All patients had undergone medical treatment for at least 3 months before the initiation of carvedilol, and no patients had received previous β-blocker therapy. Thirty-seven (80%) patients had a dilated cardiomyopathy, which included 24 with “idiopathic” cardiomyopathy, 5 with chemotherapy-related cardiomyopathy, 2 with mitochondrial
Discussion
β-Blocking agents for chronic heart failure have been studied in adults for >20 years.1, 16, 17 Carvedilol and other β-blockers have been shown in adult clinical trials to improve survival, decrease symptoms, improve ventricular function, decrease hospitalizations,1, 5, 6, 7, 8, 9, 16, 17 enhance ventricular remodeling,18 decrease free radicals and adverse neurohumoral factors,15, 19, 20 decrease arrhythmias,21 and slow progression of heart failure.7, 9 The neurohumoral mechanisms of chronic,
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Update of Pediatric Heart Failure
2020, Pediatric Clinics of North AmericaImprovement of the outcome in patients with infantile dilated cardiomyopathy over three decades – The usefulness of long-term gradually medical supportive care
2019, Journal of CardiologyCitation Excerpt :Therefore, the medical therapy for severe heart failure is important to avoid a heart transplantation. The use of ACEIs and beta-blockers appears to have some impact on the pediatric outcomes [7–9]. We reviewed the outcome in infants with DCM within 24 months over the three decades before treatment by devices in our institution.
Essentials of Cardiology
2019, A Practice of Anesthesia for Infants and ChildrenCardiac Physiology and Pharmacology
2019, A Practice of Anesthesia for Infants and ChildrenNeurohormonal targets in the treatment of pediatric heart failure
2018, Progress in Pediatric CardiologyCitation Excerpt :While the treatment of children with heart failure has come to include the use of ACE inhibitors, aldosterone antagonist, and beta-blockers, studies have failed to demonstrate the robust morbidity and mortality benefit that was seen in adults. There have been some small studies in children that support the use of beta blockers [14–19] and ACE inhibitors [20–22] in pediatric patients with ventricular dysfunction. However, the findings from these limited studies were not observed in larger trials.
Essentials of Cardiology
2018, A Practice of Anesthesia for Infants and Children
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Reprint requests: Luke A. Bruns, MD, Division of Cardiology, 3S30, St Louis Children’s Hospital, One Children’s Pl, St Louis, MO 63110.