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document
Echocardiographic evaluation of children with systemic ventricular dysfunction treated with carvedilol . Echocardiography is used to measure the therapeutic effectiveness of heart failure therapy in adults and children . The purposes of this study were ( 1 ) to assess baseline echocardiographic predictors of clinical outcome , ( 2 ) to investigate changes in echocardiographic parameters , and ( 3 ) to compare these echocardiographic changes with changes in plasma levels of b-type natriuretic peptide ( BNP ) in a population of children with systemic ventricular dysfunction and symptomatic heart failure treated with carvedilol or placebo . All available baseline and 6-month echocardiograms from Pediatric Carvedilol Trial ( PCT ) participants ( carvedilol n = 161 ; placebo n = 55 ) were reviewed . Systolic and diastolic sphericity index ( SI ; n = 110 ) , TEI index ( n = 145 ) , and systemic ventricular dP/dt ( n = 70 ) were measured . The PCT composite definition of clinical outcome ( i.e. , worsened , improved , or unchanged ) was used . For all patients , baseline TEI index was a predictor of worsened outcome . Only children treated with carvedilol showed a significant decrease in systolic SI ( P B 0.0001 ) , diastolic SI ( P B 0.0001 ) , and TEI index ( P = 0.02 ) . An inverse correlation between changes in BNP and changes in dP/dt ( r = -0.45 , P = 0.04 ) was found only in the carvedilol group . In conclusion , TEI index predicted outcome in children with systemic ventricular dysfunction and heart failure . Carvedilol may have a beneficial effect on reversal of left ventricular remodeling and global ventricular function in pediatric heart failure .
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Intervention_Pharmacological
carvedilol
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Intervention_Physical
Echocardiography
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Intervention_Pharmacological
carvedilol
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Intervention_Control
placebo
45373
Intervention_Pharmacological
carvedilol
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Intervention_Control
placebo
45375
Intervention_Pharmacological
carvedilol
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Intervention_Pharmacological
carvedilol
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Intervention_Pharmacological
Carvedilol
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Outcome_Physical
Systolic
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Outcome_Physical
diastolic sphericity index
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Outcome_Adverse-effects
worsened outcome
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Outcome_Physical
systolic SI
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Outcome_Physical
diastolic SI
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Outcome_Physical
TEI index
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Outcome_Physical
changes in BNP
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Outcome_Physical
changes in dP/dt
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Outcome_Physical
systemic ventricular dysfunction and heart failure
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Participant_Age
children
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Participant_Condition
systemic ventricular dysfunction
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Participant_Age
adults
45390
Participant_Age
children
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Participant_Age
children
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Participant_Condition
systemic ventricular dysfunction
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Participant_Condition
symptomatic heart failure