A Comprehensive Research of Pediatric Heart Failure--A Prospective Cohort Study of Drug Therapy for Pediatric Heart Failure
Overview
- Phase
- Not Applicable
- Intervention
- Captopril Tablets
- Conditions
- Heart Failure Congenital
- Sponsor
- China National Center for Cardiovascular Diseases
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- the recurrence rate of heart failure
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
The goal of this observational study is to compare the safety and effectiveness of a modified drug therapy with traditional drug therapy in pediatric heart failure patients.
The main questions it aims to answer are:
- Can a modified drug therapy improve left ventricular function in pediatric heart failure patients?
- Can the adverse drug reactions caused by the modified drug therapy be non-inferior (clinically acceptable) to those of the traditional drug therapy? Participants will be assigned to either the Modified Drug Therapy Group (comprising angiotensin-converting enzyme inhibitor (ACE-I), beta-blockers, diuretics, potassium supplements, and spironolactone) or the Traditional Drug Therapy Group (diuretics and potassium supplements) based on personal preferences and clinical assessments by their attending physicians. They will undergo a 6-months course of medication. Additionally, echocardiography, electrocardiograms, complete blood counts, biochemical tests, and measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) were conducted before the initiation of medication therapy and at 1 month, 3 months, and 6 months after treatment commencement. Researchers will compare the Modified Drug Therapy Group and the Traditional Drug Therapy Group to see if the recurrence rate of moderate to severe mitral valve regurgitation, as assessed by echocardiography after 6 months of treatment, is lower in the former than in the latter.
Investigators
Shoujun Li
Director of Congenital Heart Surgery Center
China National Center for Cardiovascular Diseases
Eligibility Criteria
Inclusion Criteria
- •Patients younger than 14 years of age
- •heart failure after congenital heart surgery
- •Ross \> 2 or NYHA \> 2
- •LVEF\<55%, or LVFS\<25%
Exclusion Criteria
- •single ventricle
- •congenital heart disease without anatomical correction
- •Patients with heart failure requiring ventricular assist or cardiac synchronization therapy
- •Patients with severe pulmonary hypertension (pulmonary arterial pressure \>6 Wood·U)
- •Patients with severe liver and kidney failure
- •Patients who are allergic to related medications
- •Patients with symptomatic hypotension who cannot tolerate related drugs
- •Refuse to sign the informed consent or refuse to participate in this experiment
Arms & Interventions
Modified Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Captopril(tablet, 0.3mg/kg, tid), Metoprolol(tablet, 0.2mg/kg, bid), Spironolactone(tablet, 2-4mg/kg, bid), Torsemide(tablet, 0.2-0.5mg/ mg, bid), and Potassium Citrate(powder, 0.06g/kg, tid).e Traditional Drug Therapy Group
Intervention: Captopril Tablets
Modified Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Captopril(tablet, 0.3mg/kg, tid), Metoprolol(tablet, 0.2mg/kg, bid), Spironolactone(tablet, 2-4mg/kg, bid), Torsemide(tablet, 0.2-0.5mg/ mg, bid), and Potassium Citrate(powder, 0.06g/kg, tid).e Traditional Drug Therapy Group
Intervention: Metoprolol Oral Tablet
Modified Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Captopril(tablet, 0.3mg/kg, tid), Metoprolol(tablet, 0.2mg/kg, bid), Spironolactone(tablet, 2-4mg/kg, bid), Torsemide(tablet, 0.2-0.5mg/ mg, bid), and Potassium Citrate(powder, 0.06g/kg, tid).e Traditional Drug Therapy Group
Intervention: Spironolactone Tablets
Modified Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Captopril(tablet, 0.3mg/kg, tid), Metoprolol(tablet, 0.2mg/kg, bid), Spironolactone(tablet, 2-4mg/kg, bid), Torsemide(tablet, 0.2-0.5mg/ mg, bid), and Potassium Citrate(powder, 0.06g/kg, tid).e Traditional Drug Therapy Group
Intervention: Torsemide Tablets
Modified Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Captopril(tablet, 0.3mg/kg, tid), Metoprolol(tablet, 0.2mg/kg, bid), Spironolactone(tablet, 2-4mg/kg, bid), Torsemide(tablet, 0.2-0.5mg/ mg, bid), and Potassium Citrate(powder, 0.06g/kg, tid).e Traditional Drug Therapy Group
Intervention: Potassium citrate powder
Traditional Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Torsemide(tablet, 0.2-0.5mg/mg, bid) and Potassium Citrate(powder, 0.06g/kg, tid).
Intervention: Torsemide Tablets
Traditional Drug Therapy Group
Patient in this group will undergo a one-year course of medication, including Torsemide(tablet, 0.2-0.5mg/mg, bid) and Potassium Citrate(powder, 0.06g/kg, tid).
Intervention: Potassium citrate powder
Outcomes
Primary Outcomes
the recurrence rate of heart failure
Time Frame: after 6 months of treatment
During follow-up visits, echocardiographic examination is conducted to measure the left ventricular function. If LVEF falls under 55%, it is recorded as a recurrence.
Secondary Outcomes
- Incidence rate of drug adverse reactions(after 6 months of treatment)
- Readmission rate for heart failure(after 6 months of treatment)
- NT-proBNP level(after 6 months of treatment)