title: Beta-Blockers (Carvedilol) in Children with Systemic Ventricle Systolic Dysfunction - Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Numerous prospective randomized clinical trials demonstrated favorable effect of beta-blockers in adults with chronic heart failure. However, effectiveness of beta blockers in pediatric patients with systemic ventricle systolic dysfunction was not recognized sufficiently. Limited number of pediatric patients might be the course of unrecognized carvediolol treatment benefit. Currently, no meta-analysis has examined the impact of carvedilol and conventional therapy on the clinical outcome in children with chronic heart failure due to impaired systemic ventricle systolic function.
  
  
  METHODS
  We have systematically searched the Medline/PubMed and Cochrane Library for the controlled clinical trials that examine carvedilol and standard treatment efficacy in pediatric patients with systemic ventricle systolic dysfunction. Mean differences for continuous variables, odds ratios for dichotomous outcomes, heterogeneity between studies and publication bias were calculated using Cochrane Review Manager (Rev Man 5.2).
  
  
  RESULTS
  Total of 8 prospective/observational studies met established criteria. Odds ratio for chronic heart failure related mortality/heart transplantation secondary to carvedilol was 0.52 (95% CI: 0.28-0.97, I(2) = 0%). Our analysis showed that carvedilol could prevent 1 death/ heart transplantation by treating 14 pediatric patients with impaired systemic ventricle systolic function.
  
  
  CONCLUSIONS
  Meta-analysis demonstrated clinical outcome benefit of carvedilol in children with chronic heart failure.
authors.affiliation: Pediatric Cardiologist, Assistant Professor of Pediatrics, Mother and Child Health Institute of Serbia, R. Dakica St. 6-8; 11070 Belgrade, Serbia and School of Medicine - University of Belgrade, Dr Subotica St. 8, 11000 Belgrade, Serbia. sergej2804@gmail.com.
authors.forename: Sergej
authors.initials: S
authors.lastname: Prijic
authors.forename: Reiner
authors.initials: R
authors.lastname: Buchhorn
authors.forename: Jovan
authors.initials: J
authors.lastname: Kosutic
authors.forename: Vladislav
authors.initials: V
authors.lastname: Vukomanovic
authors.forename: Andreja
authors.initials: A
authors.lastname: Prijic
authors.forename: Bojko
authors.initials: B
authors.lastname: Bjelakovic
authors.forename: Marija
authors.initials: M
authors.lastname: Zdravkovic
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D002648:Child; D002675:Child, Preschool; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007223:Infant; D011412:Propanolamines / Q000627:therapeutic use*; D018754:Ventricular Dysfunction / Q000150:complications*
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol