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Thorac Cardiovasc Surg 2005; 53: S129-S134
DOI: 10.1055/s-2004-830452
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© Georg Thieme Verlag KG Stuttgart · New York

Heart Failure in Pediatric Patients[*]

M. Hoch1 , H. Netz1
  • 1Department of Pediatric Cardiology and Intensive Care, Ludwig- Maximilians-University, Munich, Germany
Further Information

Publication History

Received September 30, 2004

Publication Date:
09 February 2005 (online)

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Abstract

Paradigms in understanding heart failure have changed as the knowledge of pathophysiology and its molecular basis has deepened. In the chronic compensated state of heart failure recent research has focussed on the body's regulatory mechanisms. Today heart failure is understood as a complex interplay of hemodynamic and neurohormonal factors. In pediatrics a large variety of heterogeneous conditions cause heart failure. Some require special therapeutic approaches such as the infusion of prostaglandin for ductal patency, the careful maintenance of balance between systemic and pulmonary circulations or operative treatment. In newborns with critical congenital lesions and in patients in the postoperative period management of acute heart failure becomes important. Chronic heart failure as it is understood today is present in patients with cardiomyopathies and in an increasing number of pediatric patients after palliative surgery. In heart failure due to left-to-right shunts a similar activation of compensatory neurohormonal mechanisms as in adults with chronic heart failure was found. In small clinical trials treatment of these activated compensatory mechanisms with angiotensin-converting enzyme inhibitors and β-blockers showed beneficial effects in pediatric patients. However large clinical multicenter trials as performed in the adult population should be conducted.

Key words

Heart failure - pediatrics - congenital heart disease

1 14th Münster Transplantation Meeting “Heart Failure in Pediatric Patients”, Münster, June 16, 2004

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1 14th Münster Transplantation Meeting “Heart Failure in Pediatric Patients”, Münster, June 16, 2004

Martin Hoch
Prof. Dr. med. Heinrich Netz

Abteilung für Kinderkardiologie und Päd. Intensivmedizin, Klinikum Großhadern, Ludwig-Maximilians-Universität

Marchioninistraße 15

81377 München

Germany

Email: martin.hoch@med.uni-muenchen.de

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