Cardiovascular Profile of Propranolol after Multiple Dosing in Infantile Hemangioma

Area of Science:

• Cardiology
• Pediatrics
• Dermatology

Background:

• Infantile hemangiomas are common vascular tumors in infants.
• Propranolol is increasingly the preferred treatment for complicated infantile hemangiomas.
• Understanding propranolol's cardiovascular effects in infants is crucial.

Purpose of the Study:

• To evaluate the cardiovascular safety of propranolol in infants with infantile hemangiomas.
• To assess the impact of propranolol on peripheral blood flow, oxygen saturation, and cardiac function.
• To determine changes in blood pressure and heart rate during propranolol treatment.

Main Methods:

• Prospective study of 67 infants under 12 months with infantile hemangiomas.
• Treatment with propranolol at 2 mg/kg/day for at least 4 weeks.
• Assessment of cardiovascular parameters including blood flow, O2 saturation, PR-interval, left ventricular function, blood pressure, and heart rate before and during treatment.

Main Results:

• Propranolol was well-tolerated and did not affect peripheral blood flow, O2 saturation, PR-interval, or left ventricular function.
• Absolute blood pressure remained similar, but age-adjusted systolic and diastolic blood pressure centiles were significantly lower on propranolol.
• Heart rate was significantly lower, both as an absolute value and age-adjusted centile, during propranolol treatment.

Conclusions:

• Propranolol at 2 mg/kg/day leads to a statistically significant but not clinically relevant decrease in blood pressure and heart rate in infants with infantile hemangioma.
• Cardiovascular parameters are generally unaffected in cardially healthy infants.
• Consider temporary propranolol discontinuation during acute febrile or diarrheal illnesses to prevent excessive hypotension.