[Chronic heart failure in children: recent contributions of physiopathology and therapeutic implications].
The treatment of chronic heart failure has made remarkable progress over the past ten years. Recent advances in our understanding of the pathophysiologic mechanisms involved in heart failure syndrome have led to changes in our approach to the treatment of children. The goals of the therapy have shifted from purely hemodynamic manipulation to a combination of hemodynamic and neurohumoral modulation. As for adults, three therapeutic classes have recently emerged: conversion enzyme inhibitors, spironolactone and beta-blockers. Pediatricians know that a child is not a small adult and we have to think about heart failure on the basis of etiology, the age of the patient, and circulatory physiology and maturation.
Massin
M
M
Service de cardiologie pédiatrique, université de Liège, centre hospitalier régional de la Citadelle, boulevard du Douzième-de-ligne, 1, 4000 Liège, Belgique. martial.massin@chrcitadelle.be
Coremans
C
C
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D002648:Child; D002669:Child Welfare; D004232:Diuretics / Q000627:therapeutic use; D006439:Hemodynamics; D006801:Humans; D013148:Spironolactone / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D013148:Spironolactone