Effect and safety analysis of carvedilol with metoprolol on children with dilated cardiomyopathy / 中华实用儿科临床杂志

ABSTRACT

Objective To compare the effect,safety and tolerance of carvedilol and metoprolol on children with dilated cardiomyopathy(DCM).Methods Children with DCM from Sep.2006 to Nov.2011 in Children's Hospital Affiliated to Chongqing Medical University were randomly divided into carvedilol group [(24 cases,14 doys,10 girls; (3.05 ± 3.27) years old] and metoprolol group [(24 cases,13 boys,11 girls,(3.15 ± 2.42) years old].After controlling heart failure,the patients began to take oral carvedilol starting from 0.1 mg/(kg · d) or metoprolol starting from 0.5 mg/(kg · d).The 2 groups increased dose every 2 weeks.The largest dose was respectively 0.8 mg/(kg · d) or 2.0 mg/(kg · d),then maintaining the treatment for about 12 months.Cardiothoracic ratio,left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left ventricular ejection fraction (LVEF),left ventricular shortening fraction(LVFS),left ventricular mass (LVmass),drug safety and tolerance of 2 groups after treatment were evaluated.Results Cardiothoracic ratio,LVEDV,LVESV,LVmass significantly decreased but LVEF,LVFS significantly increased after treatment in comparison with before treatment in carvedilol group and metoprolol group(all P ＜ 0.05).Heart size and function were of no significant differences between carvedilol group and metoprolol group before treatment and after treatment (all P ＞ 0.05).The tolerated dose and safety of drug was slightly higher in carvedilol group compared with metoprolol group,but they did not have statistically significant difference (P ＞ 0.05).Conclusions Both carvedilol and metoprolol can reverse left ventricular remodeling and improve cardiac function of children with DCM.Carvedilol and metoprolol have higher safety and better tolerance.Safety and tolerance of carvedilol may be better,and thus has better application prospect.