Abstract:
With continued medical and surgical advancements, most children and adolescents with congenital heart disease are expected to survive to adulthood. Chronic heart failure is increasingly being recognized as a major contributor to ongoing morbidity and mortality in this population as it ages, and treatment strategies to prevent and treat heart failure in the pediatric population are needed. In addition to primary myocardial dysfunction, anatomical and pathophysiological abnormalities specific to various congenital heart disease lesions contribute to the development of heart failure and affect potential strategies commonly used to treat adult patients with heart failure. This scientific statement highlights the significant knowledge gaps in understanding the epidemiology, pathophysiology, staging, and outcomes of chronic heart failure in children and adolescents with congenital heart disease not amenable to catheter-based or surgical interventions. Efforts to harmonize the definitions, staging, follow-up, and approach to heart failure in children with congenital heart disease are critical to enable the conduct of rigorous scientific studies to advance our understanding of the actual burden of heart failure in this population and to allow the development of evidence-based heart failure therapies that can improve outcomes for this high-risk cohort.
摘要:
随着医疗和外科的不断进步,大多数患有先天性心脏病的儿童和青少年有望存活到成年。随着年龄的增长,慢性心力衰竭越来越被认为是导致该人群持续发病和死亡的主要原因。在儿科人群中需要预防和治疗心力衰竭的治疗策略.除了原发性心肌功能障碍,各种先天性心脏病病变特有的解剖和病理生理异常会导致心力衰竭的发展,并影响通常用于治疗成年心力衰竭患者的潜在策略。这份科学声明强调了在理解流行病学方面的重大知识差距,病理生理学,分期,与慢性心力衰竭的儿童和青少年先天性心脏病不适合导管或手术干预的结果。努力协调定义,分期,后续行动,和治疗先天性心脏病儿童心力衰竭的方法对于开展严格的科学研究至关重要,以增进我们对这一人群心力衰竭的实际负担的理解,并允许开发基于证据的心力衰竭治疗方法,从而改善这一高风险队列的结局.