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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: kanamaru.hiroshi@nihon-u.ac.jp
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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 

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