Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T01:13:29.006Z Has data issue: false hasContentIssue false
  • English
  • Français

Appropriate use of a beta-blocker in paediatric coronary CT angiography

Published online by Cambridge University Press:  06 August 2018

Hirofumi Watanabe ,
Hiroshi Kamiyama ,
Masataka Kato ,
Akiko Komori ,
Yuriko Abe  and
Mamoru Ayusawa
Hirofumi Watanabe
Affiliation:
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
Hiroshi Kamiyama*
Affiliation:
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan Center for Medical Education, Nihon University School of Medicine, Tokyo, Japan
Masataka Kato
Affiliation:
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
Akiko Komori
Affiliation:
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
Yuriko Abe
Affiliation:
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
Mamoru Ayusawa
Affiliation:
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
*
Author for correspondence: H. Kamiyama, Center for Medical Education, Nihon University School of Medicine, 30-1 Kami-cho Ooyaguchi, Itabashi-ku, Tokyo 173-8610, Japan. Tel: +81 3 3972 8111, ext. 2442; Fax: +81 3 3957 6186; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Beta-blockerCT angiographyKawasaki diseasechildren
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 10 , October 2018 , pp. 1148 - 1153
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Mark, DB, Berman, DS, Budoff, MJ, et al. ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography. J Am Coll Cardiol 2010; 55: 2663–2699.Google Scholar
2. Sabarudin, A, Sun, Z. Beta-blocker administration protocol for prospectively ECG-triggered coronary CT angiography. World J Cardiol 2013; 5: 453–458.Google Scholar
3. Machida, H, Tanaka, I, Fukui, R, et al. Current and novel imaging techniques in coronary CT. Radiographics 2015; 35: 991–1010.Google Scholar
4. Araoz, PA, Kirsch, J, Primak, AN, et al. Optimal image reconstruction phase at low and high HRs in dual-source CT coronary angiography. Int J Cardiovasc Imaging 2009; 25: 837–845.Google Scholar
5. Gutstein, A, Wolak, A, Lee, C, et al. Predicting success of prospective and retrospective gating with dual-source coronary computed tomography angiography: development of selection criteria and initial experience. J Cardiovasc Comput Tomogr 2008; 2: 81–90.Google Scholar
6. Rigsby, CK, deFreitas, RA, Nicholas, AC, et al. Safety and efficacy of a drug regimen to control HR during 64-slice ECG-gated coronary CTA in children. Pediatr Radiol 2010; 40: 1880–1889.Google Scholar
7. Alabed, S, Sabouni, A, Dakhoul Al, S, Bdaiwi, Y, Frobel-Mercier, A-K. Beta-blockers for congestive heart failure in children. Cochrane Database Syst Rev, 2016; issue (1): Art.No. CD007037.Google Scholar
8. Tokunaga, C, Hiramatsu, Y, Kanemoto, S, et al. Effects of landiolol hydrochloride on intractable tachyarrhythmia after pediatric cardiac surgery. Ann Thorac Surg 2013; 95: 1685–1688.Google Scholar
9. Khan, M, Cummings, KW, Gutierrez, FR, Bhalla, S, Woodard, PK, Saeed, IM. Contraindications and side effects of commonly used medications in coronary CT angiography. Int J Cardiovasc Imaging 2011; 27: 441–449.Google Scholar
10. Fujito, K, Takayanagi, R, Kimura, K, Yokoyama, H, Yamada, Y. Evaluation of clinical bradycardiac effect and respiratory adverse effect of beta-blocking agents in coronary computed tomography angiography based on theoretical analysis. Eur J Drug Metab Pharmacokinet 2016; 41: 157–167.Google Scholar
11. Ng, MY, Karimzad, Y, Menezes, RJ, et al. Randomized controlled trial of relaxation music to reduce HR in patients undergoing cardiac CT. Eur Radiol 2016; 26: 3635–3642.Google Scholar
12. Gulec, E, Ozcengiz, D. Preoperative psychological preparation of children. Turk J Anaesth Reanim 2015; 43: 344–346.Google Scholar