title: Current pharmacologic management of pediatric heart failure in congenital heart disease.
abstract: Pharmacologic therapy represents the mainstay of treatment for heart failure in children. However, medical therapy for this population is not widely standardized. This is mainly due to the heterogeneity of potential etiologies, the specific challenge of patients with univentricular physiology and the lack of evidence-based prospective randomized clinical trials in pediatric patients. In fact, most current strategies are based largely on extrapolated data from adult studies. Although the classic drugs for heart failure, i.e. diuretics, angiotensin-converting enzyme inhibitors, ß -blockers and cardiac glycosides, still play a major role in the treatment of pediatric heart failure, newer alternative therapies such as levosimendan and nesiritide are increasingly utilized with promising early results. A systematic literature search of PubMed and MEDLINE databases using relevant terms was performed. All clinical trials and relevant manuscripts about the current pharmacologic treatment of heart failure in the pediatric population were reviewed. New drugs such as levosimendan and nesiritide and the treatment of single-ventricle patients were also included.
authors.affiliation: Department of Cardiovascular Surgery, Children´s Hospital Boston-Harvard Medical School, Boston, MA, USA. victor.bautista.hernandez@sergas.es
authors.forename: Victor
authors.initials: V
authors.lastname: Bautista-Hernandez
authors.forename: Antonio
authors.initials: A
authors.lastname: Sanchez-Andres
authors.forename: Francisco
authors.initials: F
authors.lastname: Portela
authors.forename: Francis
authors.initials: F
authors.lastname: Fynn-Thompson
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D006330:Heart Defects, Congenital / Q000150:complications* / Q000503:physiopathology; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000627:therapeutic use; D015994:Incidence; D020097:Natriuretic Peptide, Brain / Q000008:administration & dosage / Q000627:therapeutic use; D011724:Pyridazines / Q000008:administration & dosage / Q000627:therapeutic use; D000077464:Simendan
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D006835:Hydrazones; D011724:Pyridazines; D020097:Natriuretic Peptide, Brain; D000077464:Simendan