PMID- 12475466
OWN - NLM
STAT- MEDLINE
DCOM- 20030115
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 40
IP  - 11
DP  - 2002 Dec 4
TI  - Delisting of infants and children from the heart transplantation waiting list 
      after carvedilol treatment.
PG  - 2034-8
AB  - OBJECTIVES: We performed a prospective, randomized, double-blind, 
      placebo-controlled study of carvedilol effects in children with severe, chronic 
      heart failure (HF), despite the use of conventional therapy. BACKGROUND: Little 
      is known about the effects of carvedilol in youngsters with chronic HF and severe 
      left ventricular (LV) dysfunction. METHODS: We conducted a double-blind, 
      placebo-controlled study of 22 consecutive children with severe LV dysfunction. 
      The children had chronic HF and left ventricular ejection fraction (LVEF) <30%. 
      Patients were randomly assigned to receive either placebo (8 patients) or the 
      beta-blocker carvedilol (14 patients) at 0.01 mg/kg/day titrated up to 0.2 
      mg/kg/day, followed-up for six months. RESULTS: During the follow-up and the 
      up-titration period in the carvedilol group, four patients died and one underwent 
      heart transplantation. In patients receiving carvedilol evaluated after six 
      months, a significant increase occurred in LVEF, from 17.8% (95% confidence 
      interval [CI], 14.1 to 21.4%) to 34.6% (95% CI, 25.2 to 44.0%); p = 0.001. 
      Modified New York Heart Association (NYHA) functional class improved in nine 
      patients taken off the transplant waiting list. All nine patients were alive at 
      follow-up. In the placebo group, during the six-month follow-up, two patients 
      died, and two underwent heart transplantation. Four patients persisted with HF 
      symptoms (NYHA functional class IV). No significant change occurred in LVEF or 
      fractional shortening. CONCLUSIONS: Carvedilol added to standard therapy may 
      reduce HF progression and improve cardiac function, allowing some youngsters to 
      be removed from the heart transplantation waiting list.
FAU - Azeka, Estela
AU  - Azeka E
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, 
      Brazil.estela_azeka9@hotmail.com
FAU - Franchini Ramires, Jose Antonio
AU  - Franchini Ramires JA
FAU - Valler, Constante
AU  - Valler C
FAU - Alcides Bocchi, Edimar
AU  - Alcides Bocchi E
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antioxidants)
RN  - 0 (Carbazoles)
RN  - 0 (Propanolamines)
RN  - 0K47UL67F2 (Carvedilol)
SB  - IM
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Antioxidants/*therapeutic use
MH  - Blood Pressure/drug effects
MH  - Brazil
MH  - Carbazoles/*therapeutic use
MH  - Carvedilol
MH  - Child
MH  - Child Welfare
MH  - Child, Preschool
MH  - Chronic Disease
MH  - Diastole/drug effects
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/complications/diagnosis/*therapy
MH  - *Heart Transplantation
MH  - Humans
MH  - Infant
MH  - Infant Welfare
MH  - Male
MH  - Propanolamines/*therapeutic use
MH  - Prospective Studies
MH  - Radionuclide Ventriculography
MH  - Severity of Illness Index
MH  - Stroke Volume/drug effects
MH  - Systole/drug effects
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/complications/diagnosis/therapy
MH  - *Waiting Lists
EDAT- 2002/12/12 04:00
MHDA- 2003/01/16 04:00
CRDT- 2002/12/12 04:00
PHST- 2002/12/12 04:00 [pubmed]
PHST- 2003/01/16 04:00 [medline]
PHST- 2002/12/12 04:00 [entrez]
AID - S0735109702025706 [pii]
AID - 10.1016/s0735-1097(02)02570-6 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2002 Dec 4;40(11):2034-8. doi: 10.1016/s0735-1097(02)02570-6.