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KMID : 0857220040080020412
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Journal of the Korean Pediatric Cardiology Society
2004 Volume.8 No. 2 p.412 ~ p.421
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Clinical Efficacy of Carvedilol in Children with Dilated Cardiomyopathy
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Ko Jae-Youn
Chung Eun-Soo
Kim Sung-Hye
Lim Kyoung-Ah
Huh June
Kang I-Seok
Lee Heung-Jae
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Abstract
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Purpose: Clinical trials have shown that beta-blocker carvedilol is effective and well tolerated in adult patients with dilated cardiomyopathy(DCMP). Data is scarce regarding the use of carvedilol in pediatric patients with congestive heart failure(CHF). We investigated the clinical efficacy of carvedilol, the proper dose and side effects in children with moderate to severe CHF caused by DCMP.
Method: Children with DCMP, who were newly diagnosed or not improved under conventional treatment, were enrolled. Carvedilol was started initial on a daily dose of 0.1 mg/kg and was increased gradually as tolerated. Clinical functional status and left ventricular function were evaluated.
Result: Nine children(aged 4.1±3.9 years, M:F=1:2) were enrolled; 7 idiopathic DCMP and 2 anthracyclin induced DCMP. The average final dose was 0.6±0.2 mg/kg/day (range 0.3 to 0.8 mg/kg/day). The mean follow-up duration was 30.9±7.9 months after the initiation of carvedilol therapy. Functional class(NYHA functional class or Ross CHF score) improved apparently about 3 months after the use of carvedilol in 78% of the patients(P<0.05). Carvedilol was associated with a decrease in heart rate. Compared to the baseline data, left ventricle ejection fraction on the last follow-up echocardiography increased significantly. There were no serious side effects necessitating the discontinuation of carvedilol.
Conclusion: Carvedilol could be safe and effective as an adjunctive treatment for children with DCMP. Further study is needed to evaluate long-term outcome in children with myocardial dysfunction caused by various etiology.
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KEYWORD
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Beta-blocker, Carvedilol, Dilated cardiomyopathy, Child
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