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Carvedilol in children with cardiomyopathy: 3-year experience at a single institution

Paolo Rusconi1, Orlando Gómez-Marín, Marie Rossique-González

  • 1Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33101, USA. p.rusconi@miami.edu

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|July 21, 2004
PubMed

Insights

Carvedilol improves cardiac function and symptoms in children with dilated cardiomyopathy. While generally well-tolerated, careful monitoring is essential due to potential risks.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Cardiovascular Research

Background:

  • Carvedilol is established for adult congestive heart failure but understudied in pediatric populations.
  • Dilated cardiomyopathy in children presents unique treatment challenges.

Purpose of the Study:

  • To evaluate the efficacy and safety of carvedilol as adjunctive therapy in pediatric patients with dilated cardiomyopathy.
  • To assess the impact of carvedilol on cardiac function and clinical status in children.

Main Methods:

  • Retrospective review of 24 pediatric patients with dilated cardiomyopathy (ejection fraction ≤40%).
  • Carvedilol administered as adjunct to standard therapy (ACE inhibitors, digoxin, diuretics).
  • Analysis of clinical outcomes, adverse events, and changes in cardiac function parameters.

Main Results:

  • Significant improvement in left ventricular ejection fraction (24.6% to 42.2%, p < 0.001) and sphericity index (0.86 to 0.74, p < 0.001).
  • Improved New York Heart Association functional class in 68% of patients.
  • Carvedilol was generally well-tolerated, with adverse effects in 21% and discontinuation in 8%.

Conclusions:

  • Carvedilol, as part of standard therapy, enhances cardiac function and alleviates symptoms in pediatric dilated cardiomyopathy.
  • The drug is generally safe and well-tolerated in children, though close monitoring is advised.
  • Further controlled studies are needed to confirm effects on mortality and hospitalization rates.
Abstract

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