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儿科心力衰竭的重要注意事项。

Important Considerations in Pediatric Heart Failure.

机构信息

New York Medical College, Valhalla, NY, USA.

Division of Cardiology, Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA.

出版信息

Curr Cardiol Rep. 2020 Sep 10;22(11):141. doi: 10.1007/s11886-020-01383-1.

Abstract

PURPOSE OF REVIEW

The goal of this paper is to provide an overview of contemporary knowledge specific to the causes, management, and outcome of heart failure in children.

RECENT FINDINGS

While recently there have been subtle improvements in heart failure outcomes in children, these improvements lag significantly behind that of adults. There is a growing body of literature suggesting that pediatric heart failure is a unique disease process with age- and disease-specific myocardial adaptations. In addition, the heterogenous etiologies of heart failure in children contribute to differential response to therapies and challenge the ability to obtain meaningful results from prospective clinical trials. Consideration of novel clinical trial designs with achievable but clinically relevant endpoints and focused study of the mechanisms underlying pediatric heart failure secondary to cardiomyopathies and structural heart disease are essential if we hope to advance care and identify targeted and effective therapies.

摘要

目的综述

本文旨在提供有关儿童心力衰竭病因、治疗和结局的当代知识概述。

最新发现

尽管近年来儿童心力衰竭的结局有了细微改善,但与成人相比仍存在显著差距。越来越多的文献表明,儿科心力衰竭是一种具有年龄和疾病特异性心肌适应性的独特疾病过程。此外,儿童心力衰竭的病因异质性导致对治疗的反应不同,这也对从前瞻性临床试验中获得有意义的结果提出了挑战。如果我们希望推进治疗并确定针对心肌病和结构性心脏病引起的儿童心力衰竭的靶向和有效治疗方法,就需要考虑具有可实现但具有临床相关性的终点的新型临床试验设计,并深入研究其潜在机制。

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