Current concepts and challenges in pediatric diastolic dysfunction and heart failure with preserved ejection fraction

Area of Science:

• Cardiology
• Pediatric Cardiology
• Heart Failure Research

Background:

• Heart failure with preserved ejection fraction (HFpEF) is prevalent in adults, accounting for half of all heart failure cases.
• Risk factors like aging, hypertension, diabetes, and obesity contribute to the rise in adult HFpEF.
• Pediatric HFpEF is under-characterized, often associated with congenital heart disease and restrictive cardiomyopathies.

Purpose of the Study:

• To provide an overview of pediatric HFpEF, addressing diagnostic challenges and therapeutic gaps.
• To discuss recent advancements in diagnostics and emerging therapies relevant to pediatric care.
• To emphasize the need for research into pediatric HFpEF pathophysiology and treatment strategies.

Main Methods:

• Review of current literature on pediatric heart failure with preserved ejection fraction.
• Analysis of diagnostic challenges including criteria, imaging, and biomarkers.
• Exploration of emerging therapeutic strategies and their potential pediatric applications.

Main Results:

• Pediatric HFpEF diagnosis is hindered by a lack of standardized criteria and age-specific reference ranges.
• Conventional diastolic function parameters have limited sensitivity in children.
• There is a significant absence of evidence-based treatments for pediatric HFpEF, unlike in adults.

Conclusions:

• Pediatric HFpEF is an emerging condition requiring greater recognition and understanding.
• Standardized diagnostic approaches and age-specific thresholds are crucial for accurate diagnosis.
• Further research is essential to develop effective, evidence-based therapeutic strategies for pediatric HFpEF.