LABETALOL TO TREAT CHRONIC CONGESTIVE HEART FAILURE IN CHILDREN & ADOLESCENTS

儿童慢性充血性心力衰竭（CHF）是由先天性或获得性心脏病引起的最后常见途径。尽管使用地高辛、利尿剂和血管紧张素转换酶抑制剂进行标准治疗，许多儿童最终还是需要心脏移植来延长生存期。肾上腺素能阻滞已被用于成人充血性心力衰竭，从而降低发病率和死亡率。由于这些有希望的结果，我们建议检查拉贝他洛尔（一种非选择性β -和选择性α -1肾上腺素能阻滞剂）在治疗中的作用，我们打算在治疗前、维持治疗4个月和6个月后以及拉贝他洛尔治疗停止2周后，对20名儿童进行运动耐量试验、心电图和超声心动图。这项研究的意义在于有可能开发治疗儿童慢性心力衰竭的新方法。在这种情况下使用拉贝他洛尔有可能改善心功能，改善生活质量，延长生存期，降低医疗费用，推迟或排除心脏移植的需要。

Chronic congestive heart failure (CHF) in children represents a final common pathway resulting from congenital or aquired heart disease. Despite standard therapy with digoxin, diuretics, and angiotensin converting enzyme inhibitors, many children eventually require heart transplantation to prolong survival. Adrenergic blockade has been employed in adults suffering from congestive heart failure with resultant decreased morbidity and mortality. Because of these promising results in adults, we propose to examine the effects of labetalol, a nonselective beta-and selective alpha-1 adrenergic blocking agent, in the treatment, we intend to obtain exercise tolerance tests, electrocardiograms, and echocardiograms in 20 children before treatment, after 4 and 6 months of maintenance therapy, and again 2 weeks after labetalol therapy has been discontinued. The significance of this study is the potential for the development of new approaches to the treatment of chronic CHF in children. The use of labetalol in this setting has the potential to improve cardiac function, improve the quality of life, prolong survival, reduce medical care costs, and postpone or preclude the need for heart transplantation.