Title:Beta-Blockers (Carvedilol) in Children with Systemic Ventricle Systolic Dysfunction - Systematic Review and Meta-Analysis
Volume: 9
Issue: 2
Author(s): Sergej Prijic, Reiner Buchhorn, Jovan Kosutic, Vladislav Vukomanovic, Andreja Prijic, Bojko Bjelakovic and Marija Zdravkovic
Affiliation:
Keywords:
Carvedilol, childhood, systemic ventricle systolic dysfunction, heart failure.
Abstract: Background: Numerous prospective randomized clinical trials demonstrated favorable effect of beta-blockers
in adults with chronic heart failure. However, effectiveness of beta blockers in pediatric patients with systemic ventricle
systolic dysfunction was not recognized sufficiently. Limited number of pediatric patients might be the course of unrecognized
carvediolol treatment benefit. Currently, no meta-analysis has examined the impact of carvedilol and conventional
therapy on the clinical outcome in children with chronic heart failure due to impaired systemic ventricle systolic
function.
Materials and Methods: We have systematically searched the Medline/PubMed and Cochrane Library for the controlled
clinical trials that examine carvedilol and standard treatment efficacy in pediatric patients with systemic ventricle systolic
dysfunction. Mean differences for continuous variables, odds ratios for dichotomous outcomes, heterogeneity between
studies and publication bias were calculated using Cochrane Review Manager (Rev Man 5.2).
Results: Total of 8 prospective/observational studies met established criteria. Odds ratio for chronic heart failure related
mortality/heart transplantation secondary to carvedilol was 0.52 (95% CI: 0.28-0.97, I2 = 0%). Our analysis showed that
carvedilol could prevent 1 death/ heart transplantation by treating 14 pediatric patients with impaired systemic ventricle
systolic function.
Conclusion: Meta-analysis demonstrated clinical outcome benefit of carvedilol in children with chronic heart failure.