Author(s) :

Sierra Anstey.

Volume/Issue :

Abstract :

Dilated cardiomyopathy (DCM) is a cardiac disease that affects the heart’s muscles and makes it difficult for the heart to pump blood by enlarging and stiffening the heart chamber walls (usually the left ventricle). DCM is estimated to occur in 1 out of 250-2,500 adults and 0.57-1.13 out of 100,000 children. It is associated with high morbidity and mortality. Carvedilol is used off-label in children with heart failure, but its effectiveness across pediatric DCM studies remains uncertain. To synthesize reported clinical outcomes of carvedilol in patients < 18 years with DCM, a comprehensive literature was conducted in Pubmed and Embase. Eligible designs included randomized trials and cohort studies reporting carvedilol outcomes in pediatric DCM. Six studies reported improvements in left ventricular ejection fraction; two studies reported a reduction in heart rate. Across heterogeneous designs, carvedilol was generally associated with improved cardiac function in most patients, notably left ventricular ejection fraction (LVEF) and reduction in heart rate. However, dosing, co-therapies, and follow-up varied, and adverse effects were inconsistently reported. Overall, current evidence suggests carvedilol may benefit children with DCM, but larger randomized control trials are needed to confirm efficacy and safety.