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KMID : 1161220240670040178
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Clinical and Experimental Pediatrics
2024 Volume.67 No. 4 p.178 ~ p.190
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Heart failure in children and adolescents: an update on diagnostic approaches and management
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Amit Agrawal
Dalwinder Janjua
Abdulrahman Ahmed Alsayed Ali Zeyada
Ahmed Taher Elsheikh
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Abstract
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Cardiac failure is a clinical syndrome that may develop in children owing to cardiac dysfunction or underlying structural heart diseases. Considering the differences indiagnostic and therapeutic approaches for pediatric heart failure (PHF) and adult heart failure, we have reviewed the current literature on PHF. Relevant studies wereextracted from MEDLINE/PubMed, Google Scholar, and Clinical Trial Registries using the terms “pediatric heart failure” or “heart failure in children” and “management” or “decongestive therapy.” Recent advances in diagnosticapproaches, such as cardiac magnetic resonance, speckletracking echocardiography, tissue Doppler imaging, and molecular diagnostic techniques, have increased our understanding of PHF.Itis imperative that clinicians evaluate the interrelated factors responsible for the development of PHF, including myocardial function, pulmonary and systemic blood flow, heart rhythm, valve function, and nutritional status. Although recent advances have demonstrated the efficacy of many new drugs in adult heart failure trials, it cannot be concluded that these drugs will show similar efficacy in children, considering the heterogeneous nature of the underlying mechanisms and variable pharmacodynamics and pharmacokinetics. Therefore, the underlying pathophysiology of PHF and the mechanisms of actionof different drugs should be considered when selecting appropriate therapies.Further trials areneededto establish the efficacy and safety of these drugs, and a combined multidisciplinary strategy will help enhance PHF outcome.
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KEYWORD
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Heart failure, Child, Pediatrics, Tachycardia, Heart disease
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