title: Can adult heart failure regimens be applied to children:  what works and what does not?
abstract: OBJECTIVE
  Review of the evidence for current ambulatory heart failure treatment regimens in adults and their applicability in pediatric heart failure.
  
  
  RESULTS
  There is promising recent research in treatment with phosphodiesterase-5 inhibitors in single ventricle patients with heart failure, including possible benefits to reduce symptoms and improve exercise tolerance.
  
  
  CONCLUSIONS
  Therapies for adults cannot be assumed to be generally applicable to all pediatric heart failure patients, especially in patients with systemic right ventricles or single ventricle physiology. Contrary to adult heart failure regimens, evidence supports treatment of symptomatic, but not asymptomatic, heart failure with angiotensin-converting enzyme inhibitors and beta-blockers in certain pediatric patients. Implantable cardioverter defibrillators continue to be used sparingly in children compared with adults due to low risk of sudden cardiac death. Finally, cardiac resynchronization therapy may be beneficial in children with symptomatic heart failure and moderate to severe dysfunction, although applying adult criteria to children remains a challenge.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Washington University, Saint Louis, Missouri, USA. simpson_k@kids.wustl.edu
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Simpson
authors.forename: Charles E
authors.initials: CE
authors.lastname: Canter
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D002648:Child; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors