{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:44:37Z","timestamp":1789789477007,"version":"4.0.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009714","name":"Children's Cardiomyopathy Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009714","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kyle John Rymiszewski Foundation"},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL053392"],"award-info":[{"award-number":["HL053392"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Long-term studies on safety of\u00a0beta-blockers in pediatric heart failure (HF) are scant. We describe the safety profile, dose ranges, and tolerability of carvedilol in pediatric dilated cardiomyopathy (DCM). The Pediatric Cardiomyopathy Registry (PCMR) was used to identify patients with DCM, treated with carvedilol from 1997 to 2005. Descriptive statistics were analyzed and echocardiographic parameters were compared longitudinally using ANOVA. Total 118 patients were included with median age 4.4\u00a0years (interquartile range (IQR) 1.0\u201313.3). The etiology of DCM was idiopathic (66%), myocarditis (14%), familial DCM (21%). Majority (63%) had symptoms of HF at diagnosis and were on an angiotensin-converting enzyme inhibitor (ACEi) (95%) at carvedilol initiation. The mean\u2009\u00b1\u2009standard deviation (SD) carvedilol dose at 1\u00a0year was 0.38\u2009\u00b1\u20090.44\u00a0mg\/kg\/dose. The median duration of carvedilol therapy studied was 361\u00a0days (IQR 101\u2013958) with 18% of the patients treated for\u2009&gt;\u20093\u00a0years. Few patients (&lt;\u200910%) had blood pressure or heart rate below safety thresholds with no admission for hypotension or bradycardia.\u00a0Only 4 patients discontinued carvedilol for bradycardia (n\u2009=\u20091), fatigue (n\u2009=\u20091), poor LV function (n\u2009=\u20091) and worsening renal function (n\u2009=\u20091). Mean left ventricular shortening fraction (LVFS) was 16%\u2009\u00b1\u20098 at carvedilol initiation (n\u2009=\u200998), 21%\u2009\u00b1\u20099 at 1\u00a0year (n\u2009=\u200949) and 23%\u2009\u00b1\u20099 at 2\u00a0years (n\u2009=\u200920) post-carvedilol initiation, suggesting a possible clinical benefit (p\u2009&lt;\u20090.01). These results provide safety data for chronic carvedilol use in children and show a low prevalence of discontinuation for adverse events. Further study of the long-term remodeling effects of chronic beta-blocker use in pediatric HF is required.<\/jats:p>","DOI":"10.1007\/s00246-026-04409-7","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:33:53Z","timestamp":1786372433000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Tolerability of Chronic Carvedilol in Pediatric Dilated Cardiomyopathy: A Report from the Pediatric Cardiomyopathy Registry"],"prefix":"10.1007","author":[{"given":"Neha","family":"Bansal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Rossano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne T.","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Canter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfriede","family":"Pahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Towbin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Colan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Kantor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie D.","family":"Everitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean A.","family":"Ballweg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen E.","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Lipshultz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"issue":"7","key":"4409_CR1","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1161\/CIRCRESAHA.116.309386","volume":"121","author":"TM Lee","year":"2017","unstructured":"Lee TM, Hsu DT, Kantor P, Towbin JA, Ware SM, Colan SD et al (2017) Pediatric cardiomyopathies. Circ Res 121(7):855\u2013873","journal-title":"Circ Res"},{"issue":"4","key":"4409_CR2","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.hfc.2010.05.002","volume":"6","author":"JD Wilkinson","year":"2010","unstructured":"Wilkinson JD, Landy DC, Colan SD, Towbin JA, Sleeper LA, Orav EJ et al (2010) The pediatric cardiomyopathy registry and heart failure: key results from the first 15 years. Heart Fail Clin 6(4):401\u2013413, vii","journal-title":"Heart Fail Clin"},{"issue":"21","key":"4409_CR3","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.1016\/j.jacc.2017.09.1089","volume":"70","author":"RK Singh","year":"2017","unstructured":"Singh RK, Canter CE, Shi L, Colan SD, Dodd DA, Everitt MD et al (2017) Survival without cardiac transplantation among children with dilated cardiomyopathy. 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Joseph Rossano is a consultant for AskBio, Astellas, Bayer, Bristol Myers Squibb, and Merck. Steven Lipshultz is the chair of the Children\u2019s Cardiomyopathy Foundation medical advisory board and their Chief Medical Officer. Steven Lipshultz is also on the medical advisory board of Secretome Therapeutics, was also a Bayer consultant, and a member of the Roche Data Safety Monitoring Board. Steven Lipshultz has also served in the following editorial roles: American College of Cardiology (Editor), Elsevier (Editor), Biomed Central (Editor), American Heart Association (Scientific Statement Chair). All other authors have no competing interests to declare that are relevant to the content of this article.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}