Miller Tracie L, Neri Daniela, Extein Jason, Somarriba Gabriel, Strickman-Stein Nancy
Division of Pediatric Clinical Research, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL.
Prog Pediatr Cardiol. 2007 Nov;24(1):59-71. doi: 10.1016/j.ppedcard.2007.08.007.
Pediatric cardiomyopathies are heterogeneous groups of serious disorders of the heart muscle and are responsible for significant morbidity and mortality among children who have the disease. While enormous improvements have been made in the treatment and survival of children with congenital heart disease, parallel strides have not been made in the outcomes for cardiomyopathies. Thus, ancillary therapies, such as nutrition and nutritional interventions, that may not cure but may potentially improve cardiac function and quality of life, are imperative to consider in children with all types of cardiomyopathy. Growth failure is one of the most significant clinical problems of children with cardiomyopathy with nearly one-third of children with this disorder manifesting some degree of growth failure during the course of their illness. Optimal intake of macronutrients can help improve cardiac function. In addition, several specific nutrients have been shown to correct myocardial abnormalities that often occur with cardiomyopathy and heart failure. In particular, antioxidants that can protect against free radical damage that often occurs in heart failure and nutrients that augment myocardial energy production are important therapies that have been explored more in adults with cardiomyopathy than in the pediatric population. Future research directions should pay particular attention to the effect of overall nutrition and specific nutritional therapies on clinical outcomes and quality of life in children with pediatric cardiomyopathy.
小儿心肌病是心肌严重疾病的异质性群体,是患有该疾病儿童发病和死亡的重要原因。虽然先天性心脏病患儿的治疗和生存率有了巨大提高,但心肌病的治疗效果却没有取得同样的进展。因此,对于所有类型的心肌病患儿,必须考虑辅助治疗,如营养和营养干预,这些治疗可能无法治愈,但可能改善心脏功能和生活质量。生长发育迟缓是心肌病患儿最显著的临床问题之一,近三分之一患有这种疾病的儿童在患病过程中出现一定程度的生长发育迟缓。最佳的常量营养素摄入有助于改善心脏功能。此外,几种特定营养素已被证明可以纠正心肌病和心力衰竭时经常出现的心肌异常。特别是,能够抵御心力衰竭时经常发生的自由基损伤的抗氧化剂,以及增加心肌能量产生的营养素,这些重要治疗方法在成人心肌病患者中的研究比儿科患者更多。未来的研究方向应特别关注整体营养和特定营养疗法对小儿心肌病患儿临床结局和生活质量的影响。