Related Experiment Video
Updated: Jul 6, 2026
05:08
Implantation of an Isoproterenol Mini-Pump to Induce Heart Failure in Mice
Published on: October 3, 2019
Pediatric heart failure therapy with beta-adrenoceptor antagonists
Susan R Foerster1, Charles E Canter
1Department of Pediatrics, Washington University in St. Louis School of Medicine, Division of Pediatric Cardiology, St Louis, Missouri 63110, USA. foerster_s@kids.wustl.edu
Paediatric Drugs
|March 19, 2008
Summary
Beta-blockers show promise for pediatric heart failure, but a recent trial found no significant difference compared to placebo. Further research is needed to clarify their role in treating pediatric heart conditions.
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Cardiovascular Medicine
Background:
- Adult studies suggest beta-blockers improve outcomes in heart failure.
- Pediatric specialists use beta-blockers for heart failure in dilated cardiomyopathy and congenital heart disease.
- Previous pediatric case series showed encouraging results, but spontaneous recovery complicates interpretation.
Purpose of the Study:
- To review the use of beta-blockers in pediatric heart failure.
- To evaluate recent pediatric studies on beta-blocker efficacy.
- To discuss beta-blocker use in specific high-risk pediatric populations.
Main Methods:
- Review of adult and pediatric literature.
- Analysis of retrospective and prospective pediatric case series.
- Evaluation of a recent pediatric double-blind, randomized, placebo-controlled trial.
Main Results:
- A recent pediatric trial showed no difference between carvedilol and placebo over 6 months.
- All groups in the trial showed improvement, indicating a high rate of spontaneous recovery.
- Adult data suggests specific beta-blockers (carvedilol, bisoprolol, nebivolol, metoprolol succinate) are beneficial, especially in high-grade heart failure.
Conclusions:
- The role of beta-blockers in pediatric heart failure requires further investigation due to mixed results.
- Specific beta-blockers may benefit certain pediatric heart failure subsets.
- Early or prophylactic use in high-risk groups (e.g., anthracycline exposure, muscular dystrophy) warrants consideration.
Related Concept Videos
01:22Heart Failure Drugs: β-Blockers
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in bronchial smooth...
01:26Heart Failure Drugs: Inotropic Agents
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...