Cardiac diagnostics before oral propranolol therapy in infantile hemangioma: retrospective evaluation of 234 infants

作     者：Giovanni Frongia Ji-Oun Byeon Raoul Arnold Arianeb Mehrabi Patrick Günther 

作者机构：Division of Pediatric SurgeryDepartment of GeneralVisceral and Transplantation SurgeryUniversity Hospital of HeidelbergIm Neuenheimer Feld 11069120 HeidelbergGermany Department of Pediatric CardiologyCenter for Pediatrics and Adolescent MedicineUniversity Hospital of HeidelbergHeidelbergGermany Department of GeneralVisceral and Transplantation SurgeryUniversity Hospital of HeidelbergHeidelbergGermany 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2018年第14卷第3期

页      面：254-258页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Cardiac diagnostics Echocardiogram Electrocardiogram Hemangioma Propranolol 

摘      要：Background The indication and extent of cardiac screening before oral propranolol therapy (OPT) in patients with infantile hemangioma (IH) has been challenged. In this study, we evaluated pre-OPT cardiac diagnostics in a pediatric IH cohort in our department. Methods Retrospective chart review of infants ≤ 12 months old with IH undergoing OPT. The diagnostics prior to OPT, occurrence of complications, and outcome were recorded. Results A total of 234 patients were evaluated. The mean age at the onset of OPT was 4.2 ± 0.3 months, the average dura-tion of OPT was 6.1 ± 0.1 months, and the average follow-up was 12.3 ± 0.7 months. Echocardiograms and electrocardio-grams were performed prior to OPT in all patients. One hundred and three (44.0%) echocardiograms revealed pathological findings, 19 (8.1%) of which were minor (including atrial septal defects, pulmonary stenosis, and patent ductus arteriosus). Pathological findings were observed in 17 (7.3%) of electrocardiograms, only one (0.4%) of which was minor (suspected cardiac arrhythmia, subsequently excluded by long-term electrocardiogram analysis). These findings did not contraindicate OPT and no severe adverse events associated with OPT occurred during the follow-up period. Conclusions Routine cardiac screening by electrocardiogram and echocardiogram before OPT is debatable and not routinely indicated in children with IH. Further studies are necessary to draw definite conclusions on the reasonable indication and extent of this diagnostic approach.