Therapeutic Effects of Carvedilol on Systolic Function in Children with Dilated Cardiomyopathy and Heart Failure

Heart Failure (HF) and Dilated Cardiomyopathy (DCMP) are two common heart diseases among children. Carvedilol is the third generation of beta-blocker and although it has been approved in adults, very little is known about its safety, efficacy and dosing profile in children. This study is to evaluate the efficacy and safety of Carvedilol in children with HF or DCMP. This is a randomized double-blind study. We studied 30 patients with HF or DCMP for 6 months. 16 patients (2 DCMP & 14 HF) underwent standard medical therapy in addition to Carvedilol and the remained ones (2 DCMP&12 HF) received the same regimen, except the placebo instead of Carvedilol. We visited all patients on a monthly basis program and echocardiographically, evaluated them for their systolic function indices including LVEF (Left Ventricular Ejection Fraction), EPSS (E Point Septal Separation), LVESV (Left Ventricular End Systolic Volume) and LVEDV (Left Ventricular End Diastolic Volume). Data were analyzed by t-test & Mann-Whitney test. After 6 months of therapy, most of systolic function indices showed a more significant improvement in the Carvedilol group, including increase of LVEF (P=0.033) and decrease of EPSS (P=0.008) & LVESV (P=0.019). No significant side-effects were observed in our patients. Pearson correlation coefficient between some variables showed further improvement of LVEF & EPSS in males. Also, response of cardiomyopathic patients to Carvedilol was more than patients with heart failure. The Carvedilol is an effective and safe remedy for treatment of children with HF and DCMP.