Beta-adrenergic receptor blockade and pediatric dilated cardiomyopathy

β-adrenergic receptor blockers have become a mainstay of therapy for left ventricular dysfunction in adults. Alterations in adrenergic signaling that occurs in the state of heart failure, activates a complex signaling cascade that results in cardiac remodeling with increased ventricular chamber dilatation and decreased contractility. Beta-blockers mitigate this maladaptive cycle. The use and efficacy of beta-blockers on decreasing morbidities and mortality in adults with dilated cardiomyopathy has been well described. The role of beta-blockers in the treatment of children with dilated cardiomyopathy remains under investigation. This chapter will review β-adrenergic receptor blockade with regard to mechanisms of action, and highlight findings of benchmark adult clinical trials and pediatric studies.