Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas?: A cohort study

Martine F.  Raphaël; Corstiaan C Breugem; Florine A E Vlasveld; Marlies de Graaf; Martijn G Slieker; Suzanne G M A Pasmans; Johannes M P J Breur Breur

doi:10.1016/j.jaad.2014.12.019

Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas? A cohort study

Martine F. Raphaël
, Corstiaan C Breugem
, Florine A E Vlasveld
, Marlies de Graaf
, Martijn G Slieker
, Suzanne G M A Pasmans
, Johannes M P J Breur Breur

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects.

OBJECTIVES: We sought to analyze cardiovascular evaluations in patients with IH at baseline and during treatment with an oral beta-blocker.

METHODS: Data from 109 patients with IH were retrospectively analyzed. Patient and family history, pretreatment electrocardiogram (ECG), heart rate, and blood pressure were evaluated before initiation of beta-blocker therapy. Blood pressure and standardized questionnaires addressing side effects were evaluated during treatment.

RESULTS: Questionnaire analyses (n = 83) identified 3 cases with a family history of cardiovascular disease in first-degree relatives. ECG findings were normal in each case and no serious complication of therapy occurred. ECG abnormalities were found in 6.5% of patients but there were no contraindications to beta-blocker therapy and no major complications. Hypotension in 9 patients did not require therapy adjustment. In all, 88 parents (81%) reported side effects during beta-blocker treatment.

LIMITATIONS: The relatively small patient cohort is a limitation.

CONCLUSION: Pretreatment ECG is of limited value for patients with an unremarkable cardiovascular history and a normal heart rate and blood pressure. Hypotension may occur during treatment.

Original language	English
Pages (from-to)	465-472
Number of pages	8
Journal	Journal of the American Academy of Dermatology
Volume	72
Issue number	3
DOIs	https://doi.org/10.1016/j.jaad.2014.12.019
Publication status	Published - 2015

Keywords

Adrenergic beta-Antagonists
Cardiovascular Diseases
Child, Preschool
Cohort Studies
Drug Monitoring
Electrocardiography
Female
Hemangioma
Humans
Infant
Infant, Newborn
Male
Propranolol
Retrospective Studies
Skin Neoplasms

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10.1016/j.jaad.2014.12.019

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title = "Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas?: A cohort study",

abstract = "BACKGROUND: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects.OBJECTIVES: We sought to analyze cardiovascular evaluations in patients with IH at baseline and during treatment with an oral beta-blocker.METHODS: Data from 109 patients with IH were retrospectively analyzed. Patient and family history, pretreatment electrocardiogram (ECG), heart rate, and blood pressure were evaluated before initiation of beta-blocker therapy. Blood pressure and standardized questionnaires addressing side effects were evaluated during treatment.RESULTS: Questionnaire analyses (n = 83) identified 3 cases with a family history of cardiovascular disease in first-degree relatives. ECG findings were normal in each case and no serious complication of therapy occurred. ECG abnormalities were found in 6.5\% of patients but there were no contraindications to beta-blocker therapy and no major complications. Hypotension in 9 patients did not require therapy adjustment. In all, 88 parents (81\%) reported side effects during beta-blocker treatment.LIMITATIONS: The relatively small patient cohort is a limitation.CONCLUSION: Pretreatment ECG is of limited value for patients with an unremarkable cardiovascular history and a normal heart rate and blood pressure. Hypotension may occur during treatment.",

keywords = "Adrenergic beta-Antagonists, Cardiovascular Diseases, Child, Preschool, Cohort Studies, Drug Monitoring, Electrocardiography, Female, Hemangioma, Humans, Infant, Infant, Newborn, Male, Propranolol, Retrospective Studies, Skin Neoplasms",

author = "Rapha{\"e}l, \{Martine F.\} and Breugem, \{Corstiaan C\} and Vlasveld, \{Florine A E\} and \{de Graaf\}, Marlies and Slieker, \{Martijn G\} and Pasmans, \{Suzanne G M A\} and Breur, \{Johannes M P J Breur\}",

year = "2015",

doi = "10.1016/j.jaad.2014.12.019",

language = "English",

volume = "72",

pages = "465--472",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Elsevier",

number = "3",

}

TY - JOUR

T1 - Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas?

T2 - A cohort study

AU - Raphaël, Martine F.

AU - Breugem, Corstiaan C

AU - Vlasveld, Florine A E

AU - de Graaf, Marlies

AU - Slieker, Martijn G

AU - Pasmans, Suzanne G M A

AU - Breur, Johannes M P J Breur

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects.OBJECTIVES: We sought to analyze cardiovascular evaluations in patients with IH at baseline and during treatment with an oral beta-blocker.METHODS: Data from 109 patients with IH were retrospectively analyzed. Patient and family history, pretreatment electrocardiogram (ECG), heart rate, and blood pressure were evaluated before initiation of beta-blocker therapy. Blood pressure and standardized questionnaires addressing side effects were evaluated during treatment.RESULTS: Questionnaire analyses (n = 83) identified 3 cases with a family history of cardiovascular disease in first-degree relatives. ECG findings were normal in each case and no serious complication of therapy occurred. ECG abnormalities were found in 6.5% of patients but there were no contraindications to beta-blocker therapy and no major complications. Hypotension in 9 patients did not require therapy adjustment. In all, 88 parents (81%) reported side effects during beta-blocker treatment.LIMITATIONS: The relatively small patient cohort is a limitation.CONCLUSION: Pretreatment ECG is of limited value for patients with an unremarkable cardiovascular history and a normal heart rate and blood pressure. Hypotension may occur during treatment.

AB - BACKGROUND: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects.OBJECTIVES: We sought to analyze cardiovascular evaluations in patients with IH at baseline and during treatment with an oral beta-blocker.METHODS: Data from 109 patients with IH were retrospectively analyzed. Patient and family history, pretreatment electrocardiogram (ECG), heart rate, and blood pressure were evaluated before initiation of beta-blocker therapy. Blood pressure and standardized questionnaires addressing side effects were evaluated during treatment.RESULTS: Questionnaire analyses (n = 83) identified 3 cases with a family history of cardiovascular disease in first-degree relatives. ECG findings were normal in each case and no serious complication of therapy occurred. ECG abnormalities were found in 6.5% of patients but there were no contraindications to beta-blocker therapy and no major complications. Hypotension in 9 patients did not require therapy adjustment. In all, 88 parents (81%) reported side effects during beta-blocker treatment.LIMITATIONS: The relatively small patient cohort is a limitation.CONCLUSION: Pretreatment ECG is of limited value for patients with an unremarkable cardiovascular history and a normal heart rate and blood pressure. Hypotension may occur during treatment.

KW - Adrenergic beta-Antagonists

KW - Cardiovascular Diseases

KW - Child, Preschool

KW - Cohort Studies

KW - Drug Monitoring

KW - Electrocardiography

KW - Female

KW - Hemangioma

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Propranolol

KW - Retrospective Studies

KW - Skin Neoplasms

UR - https://www.scopus.com/pages/publications/84925383359

U2 - 10.1016/j.jaad.2014.12.019

DO - 10.1016/j.jaad.2014.12.019

M3 - Article

C2 - 25592625

SN - 0190-9622

VL - 72

SP - 465

EP - 472

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

IS - 3

ER -

Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas? A cohort study

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Keywords

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