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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)...



There is no standard dose or protocol for beta-blocker administration as preconditioning in children undergoing coronary CT angiography.


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.


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.


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.


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:


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