Quennelle Sophie, Bonnet Damien
Pediatric Cardiology Department, Necker-Enfants Malades Hospital, Paris, France.
Equipe Projet HeKA, Paris, France.
Front Pediatr. 2023 Aug 2;11:1137853. doi: 10.3389/fped.2023.1137853. eCollection 2023.
Diastolic dysfunction refers to a structural or functional abnormality of the left ventricle, resulting in impaired filling of the heart. Severe diastolic dysfunction can lead to congestive heart failure even when the left ventricle systolic function is normal. Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of the hospitalizations for acute heart failure in the adult population but the clinical recognition and understanding of HFpEF in children is poor. The condition is certainly much less frequent than in the adult population but the confirmatory diagnosis of diastolic dysfunction in children is also challenging. The underlying causes of HFpEF in children are diverse and differ from the main cause in adults. This review addresses the underlying causes and prognostic factors of HFpEF in children. We describe the pulmonary hypertension profiles associated with this cardiac condition. We discuss diagnosis difficulties in clinical practice, and we provide a simplified diagnostic algorithm for HFpEF in children.
舒张功能障碍是指左心室的结构或功能异常，导致心脏充盈受损。即使左心室收缩功能正常，严重的舒张功能障碍也可导致充血性心力衰竭。射血分数保留的心力衰竭（HFpEF）占成年人群急性心力衰竭住院病例的近一半，但儿童HFpEF的临床识别和理解较差。这种情况在儿童中肯定比在成年人群中少见得多，但儿童舒张功能障碍的确证诊断也具有挑战性。儿童HFpEF的潜在病因多种多样，与成人的主要病因不同。本综述探讨了儿童HFpEF的潜在病因和预后因素。我们描述了与这种心脏疾病相关的肺动脉高压特征。我们讨论了临床实践中的诊断困难，并提供了一种简化的儿童HFpEF诊断算法。
