OBJECTIVE: To evaluate the effect of carvedilol administrated during 8 months in children with heart failure secondary to dilated cardiomyopathy. METHODS: We initiated carvedilol in patients who, despite optimization of standard treatment, had persistent left ventricular ejection fraction < or = 40% and evaluated the systolic and diastolic left ventricular function before and after 4 and 8 months of treatment. RESULTS: 19 patients were included in the study, 10 women; median age: 6.7 years and 17 +/- 12.4 months after the diagnosis. The ejection fraction improved significantly from entry to eight months (median: 33.5 to 52.6%, p = 0.01) as did the shortening fraction (m: 14.8 to 25.8%, p = 0.01). The myocardial performance index abnormal in all 19 patients became normal in 5 at the end of study. In addition mitral Doppler flow which was altered in 9 improved in 3 and pulmonary venous flow abnormal in all patients improved in 13. Only 1 patient presented minimal adverse effects. CONCLUSIONS: Carvedilol added to standard therapy for dilated cardiomyopathy improves left ventricular function, is well tolerated, and has minimal adverse effects in childhood.
OBJECTIVE: To evaluate the effect of carvedilol administrated during 8 months in children with heart failure secondary to dilated cardiomyopathy. METHODS: We initiated carvedilol in patients who, despite optimization of standard treatment, had persistent left ventricular ejection fraction < or = 40% and evaluated the systolic and diastolic left ventricular function before and after 4 and 8 months of treatment. RESULTS: 19 patients were included in the study, 10 women; median age: 6.7 years and 17 +/- 12.4 months after the diagnosis. The ejection fraction improved significantly from entry to eight months (median: 33.5 to 52.6%, p = 0.01) as did the shortening fraction (m: 14.8 to 25.8%, p = 0.01). The myocardial performance index abnormal in all 19 patients became normal in 5 at the end of study. In addition mitral Doppler flow which was altered in 9 improved in 3 and pulmonary venous flow abnormal in all patients improved in 13. Only 1 patient presented minimal adverse effects. CONCLUSIONS:Carvedilol added to standard therapy for dilated cardiomyopathy improves left ventricular function, is well tolerated, and has minimal adverse effects in childhood.