Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas?: A cohort study
Raphaël, Martine F.; Breugem, Corstiaan C; Vlasveld, Florine A E; de Graaf, Marlies; Slieker, Martijn G; Pasmans, Suzanne G M A; Breur, Johannes M P J Breur
(2015) Journal of the American Academy of Dermatology, volume 72, issue 3, pp. 465 - 472
(Article)
Abstract
BACKGROUND: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects. OBJECTIVES: We sought to analyze cardiovascular evaluations in patients with IH at baseline and during treatment with an oral beta-blocker. METHODS:
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Data from 109 patients with IH were retrospectively analyzed. Patient and family history, pretreatment electrocardiogram (ECG), heart rate, and blood pressure were evaluated before initiation of beta-blocker therapy. Blood pressure and standardized questionnaires addressing side effects were evaluated during treatment. RESULTS: Questionnaire analyses (n = 83) identified 3 cases with a family history of cardiovascular disease in first-degree relatives. ECG findings were normal in each case and no serious complication of therapy occurred. ECG abnormalities were found in 6.5% of patients but there were no contraindications to beta-blocker therapy and no major complications. Hypotension in 9 patients did not require therapy adjustment. In all, 88 parents (81%) reported side effects during beta-blocker treatment. LIMITATIONS: The relatively small patient cohort is a limitation. CONCLUSION: Pretreatment ECG is of limited value for patients with an unremarkable cardiovascular history and a normal heart rate and blood pressure. Hypotension may occur during treatment.
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Keywords: Adrenergic beta-Antagonists, Cardiovascular Diseases, Child, Preschool, Cohort Studies, Drug Monitoring, Electrocardiography, Female, Hemangioma, Humans, Infant, Infant, Newborn, Male, Propranolol, Retrospective Studies, Skin Neoplasms, Evaluation Studies, Journal Article
ISSN: 0190-9622
Publisher: Mosby Inc.
Note: Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
(Peer reviewed)