Minneapolis Heart Institute and Foundation, Minnesota - EUA.
Children's Minnesota, Minneapolis, Minnesota - EUA.
Arq Bras Cardiol. 2021 Jan;116(1):100-105. doi: 10.36660/abc.20190892.
Image quality and radiation dose are optimized with a slow, steady heart rate (HR) when imaging the coronary arteries during cardiac computed tomography angiography (CCTA). The safety, efficacy, and protocol for HR reduction with beta blocker medication is not well described in a pediatric patient population.
Provide a safe and efficient metoprolol dose protocol to be used in pediatric outpatients undergoing CCTA.
We conducted a retrospective review of all pediatric outpatients who received metoprolol during CCTA. Demographic and clinical characteristics were summarized and the average reduction in HR was estimated using a multivariate linear regression model. Images were evaluated on a 1-4 scale (1= optimal).
Seventy-eight pediatric outpatients underwent a CCTA scan with the use of metoprolol. The median age was 13 years, median weight of 46 kg, and 36 (46%) were male. The median doses of metoprolol were 1.5 (IQR 1.1, 1.8) mg/kg and 0.4 (IQR 0.2, 0.7) mg/kg for oral and intravenous administrations, respectively. Procedural dose-length product was 57 (IQR 30, 119) mGy*cm. The average reduction in HR was 19 (IQR 12, 26) beats per minute, or 23%. No complications or adverse events were reported.
Use of metoprolol in a pediatric outpatient setting for HR reduction prior to CCTA is safe and effective. A metoprolol dose protocol can be reproduced when a slower HR is needed, ensuring faster acquisition times, clear images, and associated reduction in radiation exposure in this population. (Arq Bras Cardiol. 2021; 116(1):100-105).
在进行心脏 CT 血管造影（CCTA）检查时，当心率（HR）缓慢且稳定时，可优化图像质量和辐射剂量。在儿科患者人群中，β受体阻滞剂药物降低 HR 的安全性、疗效和方案尚未得到很好描述。
为接受 CCTA 的儿科门诊患者提供一种安全有效的美托洛尔剂量方案。
我们对所有接受美托洛尔治疗的儿科门诊患者进行了回顾性研究。总结了人口统计学和临床特征，并使用多元线性回归模型估计 HR 平均降低值。使用 1-4 级量表（1=最佳）对图像进行评估。
78 名儿科门诊患者接受了 CCTA 扫描并使用了美托洛尔。中位年龄为 13 岁，中位体重为 46kg，36 名（46%）为男性。美托洛尔的中位剂量分别为口服 1.5（IQR 1.1，1.8）mg/kg 和静脉注射 0.4（IQR 0.2，0.7）mg/kg。程序剂量长度乘积为 57（IQR 30，119）mGy*cm。HR 平均降低 19（IQR 12，26）次/分钟，或 23%。未报告任何并发症或不良事件。
在儿科门诊环境中，使用美托洛尔降低 HR 以进行 CCTA 检查是安全有效的。当需要更慢的 HR 时，可以复制美托洛尔剂量方案，从而确保在该人群中更快的采集时间、更清晰的图像以及相关的辐射暴露减少。（巴西心脏病学杂志。2021；116（1）：100-105）。
