Appropriate use of a beta-blocker in paediatric coronary CT angiography. (6th August 2018)

• Record Type: Journal Article
• Authors: Watanabe, Hirofumi; Kamiyama, Hiroshi; Kato, Masataka; Komori, Akiko; Abe, Yuriko; Ayusawa, Mamoru
• Is Part Of: Cardiology in the young. Volume 28:Number 10(2018)
• Page Start: 1148
• Page End: 1153
• Publication Date: 2018-08-06
• Subjects: Beta-blocker, -- CT angiography, -- Kawasaki disease, -- children; Pediatric cardiology -- Periodicals; 618.9212
• DOI: 10.1017/S104795111800118X
• Languages: English
• ISSNs: 1047-9511

Abstract

Abstract: Background: There is no standard dose or protocol for beta-blocker administration as preconditioning in children undergoing coronary CT angiography. Methods: A total of 63 consecutive patients, with a mean age of 10.0±3.1 years, who underwent coronary CT angiography to assess possible coronary complications were enrolled in a single-centre, retrospective study. All patients were given an oral beta-blocker 1 hour before coronary CT angiography. Additional oral beta-blocker or intravenous beta-blocker was given to those with a high heart rate. We compared image quality, radiation exposure, and adverse events among the patients without additional beta-blocker, with additional oral beta-blocker, and with additional intravenous beta-blocker. Results: There were no significant differences in image quality or radiation exposure among the groups. The heart rate just before scanning was significantly correlated with image quality (p<0.001, r=−0.533) but was not correlated with radiation exposure (p=0.45, r=0.096). There were no adverse events related to any allergic reaction, thereby showing the effectiveness of the beta-blocker. Conclusion: Initial oral beta-blocker administration (0.8 mg/kg/dose) should be administered to all children undergoing coronary CT angiography. Additional intravenous beta-blocker should be given to those with poor heart rate control to improve image quality without increasing radiation exposure or allowing adverse events.