Carvedilol as therapy in pediatric heart failure

An initial multicenter experience

Luke A. Bruns, Maryanne Kichuk Chrisant, Jacqueline M. Lamour, Robert E. Shaddy, Elfriede Pahl, Elizabeth D. Blume, Sara Hallowell, Linda J. Addonizio, Charles E. Canter

Research output: Contribution to journalArticle

162 Citations (Scopus)

Abstract

Objective: The objective was to determine the dosing, efficacy, and side effects of the nonselective β-blocker carvedilol for the management of heart failure in children. Study design: Carvedilol use in addition to standard medical therapy for pediatric heart failure was reviewed at 6 centers. Results: Children with dilated cardiomyopathy (80%) and congenital heart disease (20%), age 3 months to 19 years (n = 46), were treated with carvedilol. The average initial dose was 0.08 mg/kg, uptitrated over a mean of 11.3 weeks to an average maintenance dose of 0.46 mg/kg. After 3 months on carvedilol, there were improvements in modified New York Heart Association class in 67% of patients (P = .0005, χ2 analysis) and improvement in mean shortening fraction from 16.2% to 19.0% (P = .005, paired t test). Side effects, mainly dizziness, hypotension, and headache, occurred in 54% of patients but were well tolerated. Adverse outcomes (death, cardiac transplantation, and ventricular-assist device placement) occurred in 30% of patients. Conclusions: Carvedilol as an adjunct to standard therapy for pediatric heart failure improves symptoms and left ventricular function. Side effects are common but well tolerated. Further prospective study is required to determine the effect of carvedilol on survival and to clearly define its role in pediatric heart failure therapy.

Original languageEnglish (US)
Pages (from-to)505-511
Number of pages7
JournalJournal of Pediatrics
Volume138
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

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Heart Failure
Pediatrics
Therapeutics
Heart-Assist Devices
Dilated Cardiomyopathy
Dizziness
Heart Transplantation
Left Ventricular Function
Hypotension
Headache
carvedilol
Heart Diseases
Prospective Studies
Survival

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Bruns, L. A., Chrisant, M. K., Lamour, J. M., Shaddy, R. E., Pahl, E., Blume, E. D., ... Canter, C. E. (2001). Carvedilol as therapy in pediatric heart failure: An initial multicenter experience. Journal of Pediatrics, 138(4), 505-511. https://doi.org/10.1067/mpd.2001.113045

Carvedilol as therapy in pediatric heart failure : An initial multicenter experience. / Bruns, Luke A.; Chrisant, Maryanne Kichuk; Lamour, Jacqueline M.; Shaddy, Robert E.; Pahl, Elfriede; Blume, Elizabeth D.; Hallowell, Sara; Addonizio, Linda J.; Canter, Charles E.

In: Journal of Pediatrics, Vol. 138, No. 4, 2001, p. 505-511.

Research output: Contribution to journalArticle

Bruns, LA, Chrisant, MK, Lamour, JM, Shaddy, RE, Pahl, E, Blume, ED, Hallowell, S, Addonizio, LJ & Canter, CE 2001, 'Carvedilol as therapy in pediatric heart failure: An initial multicenter experience', Journal of Pediatrics, vol. 138, no. 4, pp. 505-511. https://doi.org/10.1067/mpd.2001.113045
Bruns, Luke A. ; Chrisant, Maryanne Kichuk ; Lamour, Jacqueline M. ; Shaddy, Robert E. ; Pahl, Elfriede ; Blume, Elizabeth D. ; Hallowell, Sara ; Addonizio, Linda J. ; Canter, Charles E. / Carvedilol as therapy in pediatric heart failure : An initial multicenter experience. In: Journal of Pediatrics. 2001 ; Vol. 138, No. 4. pp. 505-511.
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