A prospective, randomized, double-blind, placebo controlled trial of beta-blockade in patients who have undergone surgical correction of tetralogy of Fallot

Norozi, Kambiz; Bahlmann, J.; Raab, Björn; Alpers, Valentin; Arnhold, Jan O.; Küehne, Titus; Klimes, Katrin; Zoege, Monika; Geyer, Siegfried; Wessel, Armin; Buchhorn, Reiner

doi:10.1017/s1047951107000844

Cited by 70 publications

(43 citation statements)

References 36 publications

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“…(39) BNP and ANP levels increased when compared to patients receiving placebo. This preliminary data discourages systematic use of beta-blockers in this population.…”

Section: A B C D Ementioning

confidence: 86%

The management of tetralogy of Fallot after corrective surgery

Tretter

Morello

Chaudry

et al. 2018

SAHJ

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“…(39) BNP and ANP levels increased when compared to patients receiving placebo. This preliminary data discourages systematic use of beta-blockers in this population.…”

Section: A B C D Ementioning

confidence: 86%

The management of tetralogy of Fallot after corrective surgery

Tretter

Morello

Chaudry

et al. 2018

SAHJ

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“…In addition, patients randomized to bisoprolol actually demonstrated an increase in BNP that was not seen in the placebo group. 248 Ramipril in 64 TOF patients with pulmonary regurgitation and RV dilation, in whom the mean baseline RVEF was only mildly reduced (53%), produced no improvement in RV or LV function, exercise capacity, or degree of pulmonary regurgitation. However, RV and LV long-axis shortening significantly improved in the ramipril group, and as mentioned above, ramipril also improved LV volume and EF in patients with restrictive physiology.…”

Section: Medical Therapymentioning

confidence: 93%

Chronic Heart Failure in Congenital Heart Disease

Stout¹,

Broberg²,

Book³

et al. 2016

Circulation

293

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“…These results are in accordance with our recently published data, that show no beneficial effects of bisoprolol therapy with regard to clinical and neurohumoral activation. 40 In a multicenter study, Shaddy et al confirmed the lack of positive effect of carvedilol on children with heart defects, probably as a result of the missing benefit on right heart failure. 41 Taken together, we did not observe a reduction of cytokine concentrations in asymptomatic or minimal symptomatic TOF patients treated with bisoprolol.…”

Section: Discusssionmentioning

confidence: 96%

Beta-Blockade Does Not Alter Plasma Cytokine Concentrations and Ventricular Function in Young Adults With Right Ventricular Dysfunction Secondary to Operated Congenital Heart Disease

Norozi

Buchhorn

Wessel

et al. 2008

Circ J

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ongenital heart disease (CHD), with its worldwide incidence of 0.8%, is the most common inborn heart defect. Advances in pediatric cardiology and cardiac surgery over the past 2 decades resulted in the success that more than 85% of these patients survive to adulthood. 1 As shown recently in a 5-year follow-up survey, the spectrum of young adults with operated CHD (ACHD) consists predominantly of a young population with substantial morbidity but relatively low mortality. 2 As a result of the progress discussed above, patients and clinicians are increasingly confronted with congestive heart failure (CHF) as a Circulation Journal Vol.72, May 2008 late complication of CHD. 3 Medical management of heart failure in these patients represents a challenge because of their complex hemodynamics and the lack of evidencebased guidelines derived from large randomized controlled trials. 4 In adult patients with left ventricular heart failure, a reduction of morbidity and mortality was achieved under neurohormonal blockade. 5,6 An important question remaining to be solved is, whether or not a similar beneficial effect of -blockade could be observed in ACHD patients, who predominantly have right ventricular heart failure. Thus, we carried out, to the best of our knowledge, the first clinical trial focusing on the use of -blockade during heart failure therapy in ACHD patients. 4,7 It has been proposed that cytokines are involved in various cardiovascular diseases. [8][9][10][11] Previous results obtained by us and other researchers showed that soluble tumor necrosis factor receptors (sTNF-R) and other cytokines are reduced in adult CHF patients treated with -blockers. [12][13][14][15][16][17][18] From these data it was concluded that cytokines might be involved in, or accompany, the beneficial effects of -blocker therapy. In pre-operated infants with heart failure resulting from left-toright shunts, we showed enhanced sTNF-R concentrations, which were reduced after propranolol treatment. 19 Qing et al showed that in right ventricular tissues of infants with CHD interleukin (IL)-1 , TNF-, IL-6 and IL-10 were detectable. 20 There are also studies reporting that IL-6 and TNF-are enhanced in CHD. [21][22][23] However, no studies have shown the influence of -block- Background Right heart failure is a major problem of young adults with congenital heart disease (ACHD) that has been corrected by cardiac surgery. In left ventricular dysfunction (LVD), -blocker therapy improved cytokine concentrations and clinical status. Thus, the effect of bisoprolol on clinical status and plasma cytokine concentrations in ACHD patients with right heart failure after surgical correction for Tetralogy of Fallot was investigated. Methods and ResultsA prospective, randomized, double-blind, placebo controlled study for a duration of 6 months was carried out. A total of 34 patients (30.9±9.5 years; New York Heart Association I or II) with brain natriuretic peptide plasma concentrations >100 pg/ml and peak oxygen uptake <25 ml·kg -1 ·min -1 were recruited. ...

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A prospective, randomized, double-blind, placebo controlled trial of beta-blockade in patients who have undergone surgical correction of tetralogy of Fallot

Abstract: Beta blockade with Bisoprolol seems to have no beneficial effect on asymptomatic or mildly symptomatic patients with right ventricular dysfunction secondary to repaired tetralogy of Fallot with residual pulmonary regurgitation and/or stenosis.

Cited by 70 publications

References 36 publications

The management of tetralogy of Fallot after corrective surgery

The management of tetralogy of Fallot after corrective surgery

Chronic Heart Failure in Congenital Heart Disease

Beta-Blockade Does Not Alter Plasma Cytokine Concentrations and Ventricular Function in Young Adults With Right Ventricular Dysfunction Secondary to Operated Congenital Heart Disease

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