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Beta-Blockers (Carvedilol) in Children with Systemic Ventricle Systolic Dysfunction - Systematic Review and

Sergej Prijic1, Reiner Buchhorn, Jovan Kosutic

  • 1Pediatric Cardiologist, Assistant Professor of Pediatrics, Mother and Child Health Institute of Serbia, R. Dakica St. 6-8; 11070 Belgrade, Serbia and School of Medicine - University of Belgrade, Dr Subotica St. 8, 11000 Belgrade, Serbia. sergej2804@gmail.com.

Reviews on Recent Clinical Trials
|September 9, 2014
PubMed

Insights

Carvedilol significantly benefits children with chronic heart failure. This meta-analysis shows carvedilol reduces mortality and heart transplantation rates in pediatric patients with impaired systemic ventricle systolic function.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Beta-blockers are effective for adult chronic heart failure.
  • Carvedilol's benefit in pediatric heart failure with systolic dysfunction is under-recognized.
  • Limited pediatric data necessitates further investigation.

Purpose of the Study:

  • To evaluate carvedilol's impact on clinical outcomes in pediatric heart failure.
  • To compare carvedilol plus conventional therapy versus conventional therapy alone.
  • To assess mortality and heart transplantation rates.

Main Methods:

  • Systematic literature search of Medline/PubMed and Cochrane Library.
  • Inclusion of controlled clinical trials in pediatric patients with systolic dysfunction.
  • Meta-analysis using Cochrane Review Manager (Rev Man 5.2) for continuous and dichotomous outcomes.

Main Results:

  • Eight studies met inclusion criteria.
  • Carvedilol showed an odds ratio of 0.52 (95% CI: 0.28-0.97) for mortality/heart transplantation.
  • Carvedilol could prevent 1 death/transplantation per 14 treated pediatric patients.

Conclusions:

  • Meta-analysis confirms clinical outcome benefits of carvedilol in pediatric heart failure.
  • Carvedilol is a valuable therapeutic option for children with impaired systemic ventricle systolic function.
Abstract

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