Document Detail

Beta-Blockers in Children with Duchenne Cardiomyopathy.
MedLine Citation:
PMID:  25198739     Owner:  NLM     Status:  Publisher    
Respiratory failure and heart failure are inevitable complications in Duchenne muscular dystrophy (DMD). Respiratory failure and heart failure undergo simultaneously and affect each other. After dissemination of mechanical ventilation, heart failure is the main cause of death in DMD. Regular assessment of cardiopulmonary function, early introduction of cardioprotective therapy and intensive respiratory care are the key issues in medical managements of DMD. In DMD, angiotensin converting enzyme inhibitors (ACEI) and angiotensin II type 1 receptor blockers (ARB) are used as the first line drugs. Beta-blockers (BB) are usually added to ACEI/ARB, when they cannot achieve sufficient effects. Although high dose of BB might be required for functional improvements, even a low dose BB can reduce cardiac events. Recent meta-analysis reported heart rate reduction is more important than BB dose for reducing mortality. Thus heart rate monitoring is essential for titration of BB. Tachycardia under optimal respiratory care can also be an indicator of BB. Although the introduction of BB is relatively safe under gradual dose-escalation from a low dose, hospitalization during up-titration should be considered in advanced cases.
Tsuyoshi Matsumura
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-08
Journal Detail:
Title:  Reviews on recent clinical trials     Volume:  -     ISSN:  1876-1038     ISO Abbreviation:  Rev Recent Clin Trials     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101270873     Medline TA:  Rev Recent Clin Trials     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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