Effect of oral propranolol in pediatric chest pain with tricuspid valve regurgitation

Document Type : Original Article

Authors

1 Assistant Professor of Pediatric Cardiology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.

2 Associate Professor of Community Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.

3 Medical student, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Abstract

Background and Aim: Chest pain is one of the major complications of tricuspid valve regurgitation. Propranolol is a non-selective beta blocker that is commonly used to treat hypertension, irregular heartbeat, and cardiac pain and migraine headaches. The purpose of the present study was to evaluate the effect of oral propranolol on chest pain in children with tricuspid valve regurgitation.
Methods: In this clinical trial, 38 children aged 5 to 16 years with a symptom of chest pain due to moderate and severe tricuspid valve regurgitation were randomly divided into two groups. The case group was treated with propranolol 10 mg daily (1_0.5 mg/kg/d). Before and three months after the intervention, echocardiography was performed to assess the severity of tricuspid valve regurgitation, cardiac output, systolic and diastolic pressure and pulmonary blood pressure. In addition, patients were questioned about the duration and frequency of chest pain.
Results: There was no significant difference between two groups in the frequency and percentage of sex, location, associated heart disease and pain severity. Before intervention, pulmonary blood pressure, tricuspid valve regurgitation and ejection fraction were not significantly different between intervention and control groups. Tricuspid valve regurgitation had a significant and positive correlation with pulmonary blood pressure (p Conclusion: Propranolol significantly reduces chest pain in children with tricuspid valve regurgitation.

Keywords

References

1-Buckberg G, Nanda N, Nguyen C, Kocica M. What Is the Heart? Anatomy, Function, Pathophysiology, and Misconceptions. J Cardiovasc Dev Dis 2018;5(2):77-83.
2-Dreyfus GD, Corbi PJ, Chan KJ, Bahrami T. Secondary tricuspid regurgitation or dilatation: which should be the criteria for surgical repair? Ann Thorac Surg. 2005;79(1):127-32.
3-Dreyfus GD, Martin RP, Chan KJ, Dulguerov F, Alexandrescu C. Functional tricuspid regurgitation: a need to revise our understanding. J Am Coll Cardiol. 2015;65(21):2331-6.
4-Brand A, Dollberg S, Keren A. The prevalence of valvular regurgitation in children with structurally normal hearts: A color Doppler echocardiographic study. Am Heart J. 1992;123(1):177-80.
5-Ayabakan C, Ozkutlu S, Kilic A. The Doppler echocardiographic assessment of valvular regurgitation in normal children. Turk J Pediatr. 2003;45(2):102-7.
6-Borzuei M. The prevalence of heart valve deficiency in children with non-paratrophic cardiac murmurs. J Cardiovasc Dis 2007;5(6): 467-70.
7-Said SM, Dearani JA, Burkhart HM, Connolly HM, Eidem B, Stensrud PE, et al. Management of tricuspid regurgitation in congenital heart disease: is survival better with valve repair? The Journal of thoracic and cardiovascular surgery. 2014;147(1):412-9.
8-Ludvigsson J. Propranolol used in prophylaxis of migraine in children. Acta Neurol Scand. 1974;50(1):109-15.
9-Braunwald NS, ROSS JR J, Morrow AG. Conservative management of tricuspid regurgitation in patients undergoing mitral valve replacement. Circul. 1967;35(4s1):I-63-I-9.
10-Berger M, Haimowitz A, Van Tosh A, Berdoff RL, Goldberg E. Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol. 1985;6(2):359-65.
11-Yock PG, Popp RL. Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation. 1984;70(4):657-62.
12-Lancellotti P, Tribouilloy C, Hagendorff A, Popescu BA, Edvardsen T, Pierard LA, et al. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2013;14(7):611-44.
13-Medvedofsky D, Aronson D, Gomberg-Maitland M, Thomeas V, Rich S, Spencer K, et al. Tricuspid regurgitation progression and regression in pulmonary arterial hypertension: implications for right ventricular and tricuspid valve apparatus geometry and patients outcome. Eur Heart J Cardiovasc Imaging 2016;18(1):86-94.
14-Mascherbauer J, Kammerlander AA, Zotter-Tufaro C, Aschauer S, Duca F, Dalos D, et al. Presence of isolated tricuspid regurgitation should prompt the suspicion of heart failure with preserved ejection fraction. Plos One. 2017;12(2):e0171542.
15-Cho I-J, Oh J, Chang H-J, Park J, Kang K-W, Kim Y-J, et al. Tricuspid regurgitation duration correlates with cardiovascular magnetic resonance-derived right ventricular ejection fraction and predict prognosis in patients with pulmonary arterial hypertension. Eur Heart J Cardiovasc Imaging 2013;15(1):18-23.
16-Winkle R, Lopes M, Goodman D, Fitzgerald J, Schroeder J, Harrison D. Propranolol for patients with mitral valve prolapse. Am Heart J. 1977;93(4):422-7.
17-Moradi M, Elahi N, Khaledifar A. Assessment of the efficacy of propranolol and diltiazem on the intensity, duration and periods of pain in the angina patients referred to the heart clinic of the shahrekored university of medical sciences. J Urmia Nurs Midwifery. 2014;11(10):55-9.
18-Furberg B, Dahlqvist A, Raak A, Wrege U. Comparison of the new beta-adrenoceptor antagonist, nadolol, and propranolol in the treatment of angina pectoris. Current medical research and opinion. 1978;5(5):388-93.
19-Lynch P, Dargie H, Krikler S, Krikler D. Objective assessment of antianginal treatment: a double-blind comparison of propranolol, nifedipine, and their combination. Br Med J. 1980;281(6234):184-7.
20-Gianelly RE, Treister BL, Harrison DC. The effect of propranolol on exercise-induced ischemic ST segment depression. American Journal of Cardiology. 1969;24(2):161-5.
21-Parker JO, West RO, Di Giorgi S. Hemodynamic effects of propranolol in coronary heart disease. Am J Cardiol. 1968;21(1):11-9.
 
 
 
Jundishapur Scientific Medical Journal
Volume 17, Issue 4 - Serial Number 115
November and December 2018
Pages 347-354

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History

  • Receive Date: 23 September 2018
  • Revise Date: 19 November 2018
  • Accept Date: 19 November 2018

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