Mahrus A. Rahman, - and Enny Zuraida, - and Taufiq Hidayat, - and I Ketut Alit Utamayasa, - and Teddy Ontoseno, - (2017) The improvement chest x-ray after carvedilol therapy in heart failure due to left to right shunt, congenital heart disease. International Journal of Advanced Research, 5 (4). pp. 1134-1140. ISSN 2320-5407

	Text (Artikel) The improvement chest x-ray after carvedilol theraphy in heart failure due to left to right shunt congenital heart disease.pdf Download (261kB)
	Text (Peer Review) The improvement.pdf Download (1MB)
	Text (Similarity) The improvement chest x-ray after carvedilol theraphy in heart failure due to left to right shunt congenital heart disease.pdf Download (1MB)
	Text (Bukti Etik) Surat Keterangan The Improvement.pdf Download (361kB)
	Text (Karil) 14.pdf Download (18kB)

Abstract

Background: Heart failure due to left to right shunt congenital heart defect will increase pulmonary blood flow and cause volume overload. This condition activated the sympathetic nervous system and the renin-angiotensin-aldosteron system. Conventional therapy has not blocked the sympathetic system yet. Carvedilol, a novel non selective β-blocker, reduced mortality and hospitalization in adults with heart failure. Limited information was available about its use in children. Objective: To evaluate the effect of carvedilol on chest x-ray in children with heart failure due to left to right shunt congenital heart defect. Methods: A randomized, double-blind, placebo-controlled study was done. In addition to conventional therapy, patients were assigned to receive placebo or carvedilol. Carvedilol was initiated at a dose of 0.05 mg/kg/day, with a target dose of 0.2 mg/kg/day. Chest x-ray was done before-after treatment and evaluated for cardio-thoracic ratio and pulmonary vascularity. The data was analyzed using independent sample t-test and Chi-square test, with confidence interval 95%. Results: Of 30 patients, 15 in each group. The mean age was 57.6(SD 43.57) months, 19(63.3%) were boys. There were 21(70%) children with VSD and 9(30%) children with PDA. Compared to control group, children in the carvedilol group had a significant decrease of cardio-thoracic ratio(-2.94?2.34% versus -0.48?3.19%, p=0.023, CI 95%:-4.556 to-0.360). However, there was no significant change of pulmonary vascularity(p=0.153). Conclusion: Carvedilol decreased the cardio-thoracic ratio on chest x-ray, but did not improve the pulmonary vascularity in children with heart failure due to left to right shunt Congenital heart defect.

Actions (login required)

View Item