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Abstrait
Carvedilol among Pediatric Patients with Congestive Heart Failure
Butnariu Angela, Vlase Laurian, Leucuta Sorin, Manuel Chira and Samasca Gabriel
Congestive heart failure (CHF) as a result of systemic ventricular dysfunction represents the evolution of many heart disorders in childhood. Among these, dilated cardiomyopathy and some congenital cardiopathies are refractory to the known drug therapy, based on digitalic glycosides, diuretics and converting enzyme inhibitors. For these cases, the last therapeutic resource frequently remains heart transplantation. It is accepted that more than 50% of all children with CHF are candidates for transplantation [1]. However, transplantation involves many impediments, among which the lack of donors is the most important one. If beta-blocking agents were until not long ago contraindicated in patients with CHF, the studies carried out over the past 10 years show that beta-blocking agents improve left ventricular function, the clinical picture of CHF and survival in adults with CHF. A recent consensus on CHF in adults [2] currently recommends beta-blocking agents as part of the standard therapeutic protocol of CHF. This remarkable turn from contraindications to consensus recommendations is due to the deeper understanding of the pathophysiology of heart failure.