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

  • Hirofumi Watanabe (a1), Hiroshi Kamiyama (a1) (a2), Masataka Kato (a1), Akiko Komori (a1), Yuriko Abe (a1) and Mamoru Ayusawa (a1)...

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.

Copyright

Corresponding author

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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