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Advances in heart failure therapy in pediatric patients with dilated cardiomyopathy

Stefan Rupp1, Christian Jux2

  • 1Pediatric Heart Center, University of Giessen and Marburg, Feulgenstrasse 12, 35390, Giessen, Germany. stefan.rupp@paediat.med.uni-giessen.de.

Heart Failure Reviews
|March 23, 2018
PubMed

Insights

Pediatric heart failure treatment for dilated cardiomyopathy lags behind adult research. Current pediatric therapies include ACE inhibitors, beta-blockers, and diuretics, with evolving options like cardiac resynchronization and cell therapy.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Heart Failure Pathophysiology

Background:

  • Major advances in adult heart failure therapy contrast with lagging research in pediatric dilated cardiomyopathy.
  • Understanding the mechanisms and therapies for heart failure in children with left ventricular dilated cardiomyopathy requires further investigation.

Purpose of the Study:

  • To review current treatment guidelines for pediatric heart failure due to dilated cardiomyopathy.
  • To provide an outlook on emerging therapies for this condition in children.

Main Methods:

  • Review of existing literature and current clinical guidelines for pediatric heart failure.
  • Analysis of established and evolving therapeutic strategies.

Main Results:

  • ACE inhibitors are first-line, and beta-receptor antagonists are second-line therapies in children.
  • Mineralocorticoids are used, following adult guidelines, and diuretics are for euvolemic status.
  • Cardiac resynchronization is an option for specific conduction abnormalities; advanced therapies include pulmonary artery banding and cardiac cell therapy.

Conclusions:

  • Current pediatric heart failure management relies on adapted adult guidelines due to limited pediatric-specific data.
  • Evolving therapies offer potential future treatment avenues for pediatric dilated cardiomyopathy when standard treatments are insufficient or heart transplantation is considered.

Keywords:
Cardiac cell therapyDilated cardiomyopathyHeart failurePediatricsPulmonary artery banding

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