Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri, USA.
Curr Opin Cardiol. 2010 Mar;25(2):80-7. doi: 10.1097/HCO.0b013e328335b220.
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.
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.
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.
最近修订了美国和欧洲的成人心力衰竭治疗指南。本综述将使这些指南与儿科扩张型心肌病治疗方面的最新研究和经验相一致。
儿科扩张型心肌病的治疗包括针对特定诊断的治疗方法，以及预防蒽环类药物毒性和肌肉疾病的策略。儿科研究表明，血管紧张素转换酶抑制剂和β受体阻滞剂在扩张型心肌病中的使用是安全有效的。心脏再同步和二尖瓣环成形术代表潜在的非药物治疗方法。与成人相比，植入式除颤器治疗在儿童中的重要性可能较低。心室辅助装置（VAD）现在适用于所有年龄段，可提高生存率并有可能恢复。
新的成人心力衰竭治疗方法的成功应用也适用于扩张型心肌病患儿。严重、难治性心力衰竭的治疗方法比轻中度心力衰竭的治疗方法应用更为广泛。
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