Safety Profile Of Propranolol For Heart Rate In Children With Infantile Hemangioma And Ultrasound In Assessing The Efficacy Of Propranolol Therapy For Infantile Hemangioma

Objective: To evaluate the influence of propranolol on heart rates in patients with infantile hemangioma(IH), and assess the efficacy of propranolol treatment in IH by ultrasound.Methods: Thirty-one patients with IH were administered propranolol at 0.67mg/(kg*d) per day as a single dose, gradually increased to the full dose(2 mg/(kg*d)), which was given in three divided doses. Heart rates were recorded before treatment and were closely monitored during treatment. we assessed the efficacy of ultrasound in identifying changes in IH size, morphology and blood flow in patients before, during and at the end of propranolol treatment.Results: All heart rates monitored during treatment were found to be within the normal range. Fluctuations in heart rates were observed after every dose from the first day to the first dose of the sixth day; however, from the second dose of the sixth day onwards, no significant differences in heart rates were observed after each dose on successive days. During the second week of drug therapy, no significant differences in heart rates were observed at 1 h after the first dose(P=1.00). Also, no significant differences(P=0.73) in heart rates were observed between patients and controls at 1 h after the first dose on Mondays from week 1 to 16 of treatment. Longitudinal and transverse diameters, as well as thickness of hemangiomas measured by clinical observation differed significantly(p < 0.05) from measurements obtained by ultrasound. Ultrasound also revealed that longitudinal and transverse diameters, thickness, vascular density, blood flow velocity(arterial and venous) and arterial peak systolic blood flow velocity of hemangiomas were significantly decreased(p<0.05) after treatment compared with before treatment. The resistive index and systolic/diastolic blood flow velocity in IHs were significantly higher(p<0.05) after treatment than before treatment.Conclusions: A three-times-daily dosing regimen of propranolol had no significant sustained effects on heart rates in subjects with IH. Ultrasound can evaluate the efficacy of propranolol at the termination of therapy and has the potential to guide clinicians in making better decisions on when to stop propranolol therapy.