[The place of new therapies in the treatment of congestive heart failure. The combination of digitalis and diuretics is always in good place].
In recent years, thanks to a better understanding of the pathophysiology of congestive heart failure and progress made in the pharmacology of cardiovascular drugs, new therapeutics have been advocated in the treatment of congestive heart failure. Among them, converting enzyme inhibitors are the most useful. However, the classical association of digoxin-furosemide and general measures remains a very effective first-choice treatment in most cases. Only in particular situations, such as cardiomyopathy and decompensated atrio-ventricular insufficiency, should priority be given to converting enzyme inhibitors. Phosphodiesterase inhibitors are essentially used within the context of post-cardiac surgery intensive care. Beta-blockers which have been recently proposed for treatment of adult patients must not be used, as there is still no data available on their effectiveness and tolerance in pediatric patients.
André
M
M
Service de cardiologie pédiatrique, Hôpital Cardiologique, Lyon, France.
Normand
J
J
Bozio
A
A
Sassolas
F
F
Jocteur-Monrozier
D
D
D000367:Age Factors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004077:Digoxin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004078:Dihydralazine / Q000008:administration & dosage / Q000627:therapeutic use; D004298:Dopamine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000150:complications; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male
D000806:Angiotensin-Converting Enzyme Inhibitors; D004077:Digoxin; D005665:Furosemide; D002216:Captopril; D004078:Dihydralazine; D004298:Dopamine
Place des nouveautés thérapeutiques dans le traitement de l'insuffisance cardiaque. L'association digitalo-diurétique toujours en bonne place.