Masarone Daniele, Valente Fabio, Rubino Marta, Vastarella Rossella, Gravino Rita, Rea Alessandra, Russo Maria Giovanna, Pacileo Giuseppe, Limongelli Giuseppe
Cardiologia SUN - Heart Failure Unit, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
Cardiologia SUN - Heart Failure Unit, Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy.
Pediatr Neonatol. 2017 Aug;58(4):303-312. doi: 10.1016/j.pedneo.2017.01.001. Epub 2017 Feb 1.
Pediatric heart failure represents an important cause of morbidity and mortality in childhood. Currently, there are well-established guidelines for the management of heart failure in the adult population, but an equivalent consensus in children is lacking. In the clinical setting, ensuring an accurate diagnosis and defining etiology is essential to optimal treatment. Diuretics and angiotensin-converting enzyme inhibition are the first-line therapies, whereas beta-blockers and devices for electric therapy are less used in children than in adults. In the end-stage disease, heart transplantation is the best choice of treatment, while a left ventricular assist device can be used as a bridge to transplantation (due to the difficulties in finding organ donors), recovery (in the case of myocarditis), or destination therapy (for patients with systemic disease).
小儿心力衰竭是儿童发病和死亡的重要原因。目前，针对成人心力衰竭的管理已有完善的指南，但儿童方面缺乏类似的共识。在临床环境中，确保准确诊断并明确病因对于优化治疗至关重要。利尿剂和血管紧张素转换酶抑制剂是一线治疗方法，而β受体阻滞剂和电疗设备在儿童中的使用比成人少。在疾病终末期，心脏移植是最佳治疗选择，而左心室辅助装置可作为移植的桥梁（由于寻找器官供体困难）、恢复（如心肌炎情况）或目标治疗（用于患有全身性疾病的患者）。
