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Pediatric Heart Failure Pharmacotherapy: Transformative Insights for the Future
1Pediatric Cardiology, Methodist Children's Hospital, San Antonio, TX 78229, USA.
Reviews in Cardiovascular Medicine
|December 8, 2025
Summary
Pediatric heart failure (HF) pharmacotherapy is evolving with new guidelines and therapies. Individualized treatment based on patient hemodynamics is crucial for better outcomes in children with HF.
Area of Science:
- Cardiology
- Pharmacology
- Pediatrics
Background:
- Pediatric heart failure (HF) management is complex due to varied causes and limited child-specific data.
- Historically, treatments relied on adult evidence, but pediatric-focused therapies are emerging.
Purpose of the Study:
- To review current pharmacotherapy for pediatric HF and discuss future directions.
- To highlight the need for personalized treatment strategies in children with HF.
Main Methods:
- Comprehensive literature search of PubMed, Scopus, and Google Scholar for recent publications.
- Inclusion of adult HF data for context and bridging pediatric evidence gaps.
- Prioritization of pediatric-specific data for applicability.
Main Results:
- Current pediatric HF guidelines incorporate four main drug classes: ACE inhibitors/ARBs/ARNIs, beta-blockers, MRAs, and SGLT2 inhibitors.
- Multicenter registries are contributing to evidence-informed, personalized pediatric HF care.
- Treatment stratification by HF phenotypes (HFrEF/HFpEF) is challenging in children.
Conclusions:
- A one-size-fits-all approach is inadequate for chronic pediatric HF.
- Individualizing treatment based on hemodynamic profiles is essential for improving outcomes.
- Precision-based care is needed to address the unique needs of children with HF.
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