Beta-blocker therapy in young children with congestive heart failure under consideration for heart transplantation.

BACKGROUND: Although beta-blocker therapy for dilated or ischemic cardiomyopathy is now an accepted and effective treatment in adults, little is known about its efficacy in children. METHODS: We reviewed our experience with the use of metoprolol in four younger children with cardiomyopathy who were referred for consideration for heart transplantation because of severe congestive heart failure. RESULTS: Over a follow-up period of 12.6 +/- 6 months, left ventricular fractional shortening increased from 13.8% +/- 7% to 25.5% +/- 13%, and ejection fraction increased from 19.8% +/- 11% to 40.8% +/- 21% (p < 0.05). Two children became asymptomatic. CONCLUSION: Metoprolol may be effective in improving ejection fraction and symptoms in some young children with cardiomyopathy and congestive heart failure.