Current management of pediatric dilated cardiomyopathy.
OBJECTIVE
American and European guidelines for treatment of adult heart failure have been recently revised. This review will reconcile those guidelines to recent studies and experience in the treatment of pediatric dilated cardiomyopathy.


RESULTS
Therapy for pediatric dilated cardiomyopathy includes establishing a diagnosis for diagnostic-specific therapies as well as preventive strategies for anthracycline toxicity and muscular dystrophy. Pediatric studies demonstrate safety and efficacy for use of angiotensin-converting enzyme inhibition and beta-blockers in dilated cardiomyopathy. Cardiac resynchronization and mitral annuloplasty represent potential nonpharmacologic therapies. Implantable defibrillator therapy may be of less import in children as compared with adults. Ventricular assist devices (VADs) are now available for all ages, which can improve survival and potentially can lead to recovery.


CONCLUSIONS
The robust development of new therapies for adult heart failure has been successfully applied to children with dilated cardiomyopathy. Therapies for severe, intractable heart failure have been more widely utilized than therapies for mild-to-moderate heart failure.
Silva
Jennifer N A
JN
Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri, USA. silva_j@kids.wustl.edu
Canter
Charles E
CE
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D058406:Cardiac Resynchronization Therapy; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002669:Child Welfare; D017147:Defibrillators, Implantable; D006333:Heart Failure / Q000188:drug therapy / Q000628:therapy; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents