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Published on: February 13, 2021

Can adult heart failure regimens be applied to children: what works and what does not?

Kathleen E Simpson1, Charles E Canter

  • 1Division of Cardiology, Department of Pediatrics, Washington University, Saint Louis, Missouri, USA. simpson_k@kids.wustl.edu

Current Opinion in Cardiology
|January 18, 2012
PubMed

Insights

Pediatric heart failure treatments differ from adult regimens. Angiotensin-converting enzyme inhibitors and beta-blockers are for symptomatic pediatric patients, unlike adults, and other therapies require careful consideration.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Medicine
  • Clinical Therapeutics

Background:

  • Pediatric heart failure (HF) treatment lags behind adult protocols.
  • Limited evidence exists for applying adult HF therapies to pediatric populations.

Purpose of the Study:

  • To review current ambulatory HF treatment evidence in adults.
  • To assess the applicability of these adult regimens to pediatric HF.

Main Methods:

  • Systematic review of existing literature on adult and pediatric HF treatments.
  • Analysis of treatment efficacy and safety data.

Main Results:

  • Phosphodiesterase-5 inhibitors show promise in single ventricle pediatric HF patients.
  • Adult HF therapies are not universally applicable to pediatric cases, particularly those with single ventricle physiology.
  • Angiotensin-converting enzyme inhibitors and beta-blockers are recommended for symptomatic pediatric HF, not asymptomatic.
  • Implantable cardioverter defibrillators are used less in children due to lower sudden cardiac death risk.
  • Cardiac resynchronization therapy may benefit pediatric HF with moderate to severe dysfunction.

Conclusions:

  • Pediatric HF management requires tailored approaches, distinct from adult guidelines.
  • Specific pediatric HF populations necessitate individualized therapeutic strategies.
  • Further research is needed to optimize HF treatment in children.
Abstract

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