β-Blocker therapy in young children with congestive heart failure under consideration for heart transplantation

Background Although beta-blocker therapy for dilated or ischemic cardiomyopathy is now an accepted and effective treatment in adults, little is known about its efficacy in children. Methods we reviewed our experience with the use of metoprolol in four younger children with cardiomyopathy who were referred for consideration for heart transplantation because of severe congestive heart Failure. Results over a follow-up period of 12.6 +/- 6 months, left ventricular fractional shortening increased from 13.8% +/- 7% to 25.5% +/- 13%, and election fraction increased from 19.8% +/- 11% to 40.8% +/- 21% (p < 0.05). Two children became asymptomatic. Conclusion Metoprolol may be effective in improving ejection fraction and symptoms in some young children with cardiomyopathy and congestive heart failure.