β-blockers have become an essential component of pharmacological therapy for adults with chronic congestive heart failure (CHF). They have been shown to decrease morbidity and mortality in several randomized controlled studies. Nonetheless, one has to take into consideration some of the differences that exist between pediatric and adult heart failure when considering β-blockers. Heart failure in adults is most often a problem caused by left ventricular (LV) systolic dysfunction that occurs with damage from ischemia, hypertension, or older age. Pediatric heart failure can be secondary to primary systolic dysfunction that is either acquired or congenital but most commonly is caused by congenital structural defects. Patients born with single ventricle defects, and especially those with a single right ventricle, seem to be particularly prone to ventricular dysfunction over time. Despite these differences in the etiology of heart failure, there is substantial evidence that infants and children have alterations in their neurohormonal axes that are similar to adults.
KeywordsSevere Heart Failure Chronic Congestive Heart Failure Abrupt Withdrawal Dihydropyridine Calcium Channel Blocker Carvedilol Therapy
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