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Dr. Samuel S. Gidding, an attending cardiologist at the Nemours Cardiac Center in Wilmington, Del., who wrote an accompanying editorial in the journal, said, "This study was underpowered [small in numbers] to show a benefit. The causes of heart failure in children are very different from the causes of heart failure in adults. Also, the drug is metabolized more quickly in children, so some patients are under-dosed, and there is a different response to drugs based on the disease class."

The study shows the hazards of extrapolating treatment results in adults to children, Gidding said. "We would need to be a lot more aggressive in trials in children to show what works and what doesn't work," he said. "We need much bigger clinical trials in kids rather than imposing conclusions from adult trials."

If further studies are to be done, Shaddy said, "we would recommend that they be done with a more homogeneous group, children with one type of heart disease."

"Children are not little adults," Gidding added. "In adulthood, there is a lot more wear and tear on the body."

More information

You can learn more about beta-blocker drugs from the Texas Heart Institute.

SOURCES: Robert E. Shaddy, M.D., chief, division of cardiology, Children's Hospital of Philadelphia; Samuel S. Gidding, M.D., attending cardiologist, Nemours Cardiac Center, Wilmington, Del.; Sept. 12, 2007, Journal of the American Medical Association