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KMID : 0857220060100020145
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Journal of the Korean Pediatric Cardiology Society
2006 Volume.10 No. 2 p.145 ~ p.151
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Management of Chronic Heart Failure in Congenital Heart Disease
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Jang Gi-Young
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Abstract
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The medical treatment of heart failure has evolved over the past 40 years, from the use of diuretics and digitalis in the 1960s to the use of inotropic agents and vasodilators in the 1970s. However, while vasodilators and inotropic drugs immediately improved symptoms, hemodynamics and functional status, in the long term they either did not affect or worsen the natural history of heart failure. In the late 1980s and 1990s heart failure has evolved into a more complex and interactive pathophysiologic disorder. As the importance of neurohormonal changes in the pathogenesis of worsening heart failure is elucidated, newer medications aimed at counteracting such changes are becoming more important in the medical therapy of heart failure. For example, angiotensin converting enzyme inhibitors improve function and survival in adults with heart failure, and they probably do the same in children with systemic ventricular dysfunction. Beta-blockers has also been established as an effective therapy for adults with heart failure with beneficial effects on survival and ventricular function. While data for the pediatric population are limited, early studies suggest that beta-blockers may work well in children with heart failure. This review will address the current thinking and therapeutic modalities used today in the treatment of heart failure syndrome.
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KEYWORD
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Chronic heart failure, Treatment
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