ISSN - 0973-0958

Pediatric Oncall Journal View Article

Emerging Therapies for Chronic Heart Failure in Children and Young Adults
Bibhuti B Das, Robert Solinger.
Division of Cardiology,Department of Pediatrics, University of Louisville, Louisville, USA.
The pace at which the base of knowledge has expanded, and the number of new studies published, there is a need to rethink future management of heart failure in children and young adults. The clinical evidences from adults suggest that the neurohormonal explanation of progression of heart failure is not complete and ventricular remodeling is an important pathophysiologic mechanism for initiation and progression of heart failure. Therefore, treatment of heart failure should be aimed both at neurohormonal modulation and at reversing the ventricular remodeling process. In this review we have discussed not only conventional remedies, but also newer drugs and therapies that are on the horizon, including angiotensin-converting enzyme inhibitors, beta-blockers, exogenous brain natriuretic peptide (nesiritide), blockers of angiotensin-receptors, calcium sensitizing agents, modulation of the cytokine response, endothelin receptor antagonists, vasopressin antagonists, chronic resynchronization therapy and/or implantable defibrillator, and implantable circulatory assist device support for heart failure in children and young adults. The need to care effectively for the increasing population of children and young adults with heart failure urges more prospective controlled studies in children to improve prognosis of heart failure.

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