Carvedilol in children with cardiomyopathy

3-Year experience at a single institution

Paolo Rusconi, Orlando W Gomez-Marin, Marie Rossique-González, Esmail Redha, Jennifer R. Marín, Ming Lon-Young, Grace S. Wolff

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Background Carvedilol reduces mortality and hospitalization in adults with congestive heart failure. Limited information is available about its use in children. Methods We reviewed the medical records of 24 children with dilated cardiomyopathy and left ventricular ejection fraction of ≤40%, who were treated with carvedilol as adjunct therapy to angiotensin-converting enzyme inhibitors, digoxin and diuretics. Results Carvedilol was initiated 14.3 ± 23.3 (mean ± SD) months after the diagnosis of cardiomyopathy. Mean age at initiation of therapy was 7.2 ± 6.4 years. The mean initial and maximum doses were 0.15 ± 0.09 and 0.98 ± 0.26 mg/kg/day. Adverse effects occurred in 5 patients (21%). Two patients (8%) required discontinuation of the drug within 5 weeks of the initial dose. The remaining 22 patients tolerated carvedilol for a mean follow-up period of 26.6 ± 14.7 months. Among these 22 patients, mean left ventricular ejection fraction improved from 24.6 ± 7.6% to 42.2 ± 14.2% (p < 0.001), and mean sphericity index from 0.86 ± 0.11 to 0.74 ± 0.10 (p < 0.001). New York Heart Association functional class improved in 15 patients (68%). One patient (4%) died and 3 (14%) were transplanted. Conclusions Carvedilol, in addition to standard therapy for dilated cardiomyopathy in children improves cardiac function and symptoms; it is well tolerated, with minimal adverse effects, but close monitoring is necessary as it might worsen congestive heart failure and precipitate asthma. Control studies are necessary to assess the effect of carvedilol on mortality and hospitalization rates.

Original languageEnglish
Pages (from-to)832-838
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume23
Issue number7
DOIs
StatePublished - Jul 1 2004

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Cardiomyopathies
Dilated Cardiomyopathy
Stroke Volume
Hospitalization
Heart Failure
Mortality
Digoxin
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Medical Records
carvedilol
Therapeutics
Asthma
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Rusconi, P., Gomez-Marin, O. W., Rossique-González, M., Redha, E., Marín, J. R., Lon-Young, M., & Wolff, G. S. (2004). Carvedilol in children with cardiomyopathy: 3-Year experience at a single institution. Journal of Heart and Lung Transplantation, 23(7), 832-838. https://doi.org/10.1016/j.healun.2003.07.025

Carvedilol in children with cardiomyopathy : 3-Year experience at a single institution. / Rusconi, Paolo; Gomez-Marin, Orlando W; Rossique-González, Marie; Redha, Esmail; Marín, Jennifer R.; Lon-Young, Ming; Wolff, Grace S.

In: Journal of Heart and Lung Transplantation, Vol. 23, No. 7, 01.07.2004, p. 832-838.

Research output: Contribution to journalArticle

Rusconi, P, Gomez-Marin, OW, Rossique-González, M, Redha, E, Marín, JR, Lon-Young, M & Wolff, GS 2004, 'Carvedilol in children with cardiomyopathy: 3-Year experience at a single institution', Journal of Heart and Lung Transplantation, vol. 23, no. 7, pp. 832-838. https://doi.org/10.1016/j.healun.2003.07.025
Rusconi, Paolo ; Gomez-Marin, Orlando W ; Rossique-González, Marie ; Redha, Esmail ; Marín, Jennifer R. ; Lon-Young, Ming ; Wolff, Grace S. / Carvedilol in children with cardiomyopathy : 3-Year experience at a single institution. In: Journal of Heart and Lung Transplantation. 2004 ; Vol. 23, No. 7. pp. 832-838.
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abstract = "Background Carvedilol reduces mortality and hospitalization in adults with congestive heart failure. Limited information is available about its use in children. Methods We reviewed the medical records of 24 children with dilated cardiomyopathy and left ventricular ejection fraction of ≤40{\%}, who were treated with carvedilol as adjunct therapy to angiotensin-converting enzyme inhibitors, digoxin and diuretics. Results Carvedilol was initiated 14.3 ± 23.3 (mean ± SD) months after the diagnosis of cardiomyopathy. Mean age at initiation of therapy was 7.2 ± 6.4 years. The mean initial and maximum doses were 0.15 ± 0.09 and 0.98 ± 0.26 mg/kg/day. Adverse effects occurred in 5 patients (21{\%}). Two patients (8{\%}) required discontinuation of the drug within 5 weeks of the initial dose. The remaining 22 patients tolerated carvedilol for a mean follow-up period of 26.6 ± 14.7 months. Among these 22 patients, mean left ventricular ejection fraction improved from 24.6 ± 7.6{\%} to 42.2 ± 14.2{\%} (p < 0.001), and mean sphericity index from 0.86 ± 0.11 to 0.74 ± 0.10 (p < 0.001). New York Heart Association functional class improved in 15 patients (68{\%}). One patient (4{\%}) died and 3 (14{\%}) were transplanted. Conclusions Carvedilol, in addition to standard therapy for dilated cardiomyopathy in children improves cardiac function and symptoms; it is well tolerated, with minimal adverse effects, but close monitoring is necessary as it might worsen congestive heart failure and precipitate asthma. Control studies are necessary to assess the effect of carvedilol on mortality and hospitalization rates.",
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AU - Redha, Esmail

AU - Marín, Jennifer R.

AU - Lon-Young, Ming

AU - Wolff, Grace S.

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N2 - Background Carvedilol reduces mortality and hospitalization in adults with congestive heart failure. Limited information is available about its use in children. Methods We reviewed the medical records of 24 children with dilated cardiomyopathy and left ventricular ejection fraction of ≤40%, who were treated with carvedilol as adjunct therapy to angiotensin-converting enzyme inhibitors, digoxin and diuretics. Results Carvedilol was initiated 14.3 ± 23.3 (mean ± SD) months after the diagnosis of cardiomyopathy. Mean age at initiation of therapy was 7.2 ± 6.4 years. The mean initial and maximum doses were 0.15 ± 0.09 and 0.98 ± 0.26 mg/kg/day. Adverse effects occurred in 5 patients (21%). Two patients (8%) required discontinuation of the drug within 5 weeks of the initial dose. The remaining 22 patients tolerated carvedilol for a mean follow-up period of 26.6 ± 14.7 months. Among these 22 patients, mean left ventricular ejection fraction improved from 24.6 ± 7.6% to 42.2 ± 14.2% (p < 0.001), and mean sphericity index from 0.86 ± 0.11 to 0.74 ± 0.10 (p < 0.001). New York Heart Association functional class improved in 15 patients (68%). One patient (4%) died and 3 (14%) were transplanted. Conclusions Carvedilol, in addition to standard therapy for dilated cardiomyopathy in children improves cardiac function and symptoms; it is well tolerated, with minimal adverse effects, but close monitoring is necessary as it might worsen congestive heart failure and precipitate asthma. Control studies are necessary to assess the effect of carvedilol on mortality and hospitalization rates.

AB - Background Carvedilol reduces mortality and hospitalization in adults with congestive heart failure. Limited information is available about its use in children. Methods We reviewed the medical records of 24 children with dilated cardiomyopathy and left ventricular ejection fraction of ≤40%, who were treated with carvedilol as adjunct therapy to angiotensin-converting enzyme inhibitors, digoxin and diuretics. Results Carvedilol was initiated 14.3 ± 23.3 (mean ± SD) months after the diagnosis of cardiomyopathy. Mean age at initiation of therapy was 7.2 ± 6.4 years. The mean initial and maximum doses were 0.15 ± 0.09 and 0.98 ± 0.26 mg/kg/day. Adverse effects occurred in 5 patients (21%). Two patients (8%) required discontinuation of the drug within 5 weeks of the initial dose. The remaining 22 patients tolerated carvedilol for a mean follow-up period of 26.6 ± 14.7 months. Among these 22 patients, mean left ventricular ejection fraction improved from 24.6 ± 7.6% to 42.2 ± 14.2% (p < 0.001), and mean sphericity index from 0.86 ± 0.11 to 0.74 ± 0.10 (p < 0.001). New York Heart Association functional class improved in 15 patients (68%). One patient (4%) died and 3 (14%) were transplanted. Conclusions Carvedilol, in addition to standard therapy for dilated cardiomyopathy in children improves cardiac function and symptoms; it is well tolerated, with minimal adverse effects, but close monitoring is necessary as it might worsen congestive heart failure and precipitate asthma. Control studies are necessary to assess the effect of carvedilol on mortality and hospitalization rates.

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