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Drug Treatment of Heart Failure in Children: Focus on Recent Recommendations from the ISHLT Guidelines for the Management of Pediatric Heart Failure

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Abstract

The International Society of Heart and Lung Transplantation (ISHLT) recently updated consensus pediatric heart failure guidelines from those published in 2004 with an aim to provide a practical evidence-based resource whilst recognizing the influence of adult heart failure practice. The new guidelines were formed from published evidence for heart failure management and used parallels with adult literature where pediatric evidence was lacking. This is a summary of the pharmacological therapies discussed in the new 2014 guidelines, emphasizing changes from the previous recommendations with regards to treatment of chronic heart failure with reduced ejection fraction, chronic heart failure with preserved ejection fraction, and acute decompensated heart failure. Each recommendation is classified according to strength and level of evidence. We also discuss future perspectives in the pharmacological treatment of heart failure. The 2014 ISHLT guidelines have evolved considerably from those published in 2004 with extensive information surrounding the underlying pathophysiology, investigations and recommended treatment. The new guidelines contain a modest amount of new pediatric data on pharmacological therapies and extrapolate adult data when appropriate. It is likely that most new recommendations for pediatric heart failure will continue to be based on therapies of proven benefit in adult heart failure studies.

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Authors and Affiliations

  1. Department of Cardiology, Royal Children’s Hospital, Flemington Road, Parkville, VIC, 3052, Australia

    Alexander D. Hussey & Robert G. Weintraub

  2. Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC, Australia

    Robert G. Weintraub

  3. University of Melbourne, Parkville, VIC, Australia

    Robert G. Weintraub

Authors
  1. Alexander D. Hussey
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  2. Robert G. Weintraub
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Correspondence to Robert G. Weintraub.

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No external funding was used in the preparation of this manuscript.

Conflict of interest

Dr Weintraub serves on an advisory board for Actelion Pharmaceuticals. Dr Hussey has no conflicts of interest to declare.

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Hussey, A.D., Weintraub, R.G. Drug Treatment of Heart Failure in Children: Focus on Recent Recommendations from the ISHLT Guidelines for the Management of Pediatric Heart Failure. Pediatr Drugs 18, 89–99 (2016). https://doi.org/10.1007/s40272-016-0166-4

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  • DOI: https://doi.org/10.1007/s40272-016-0166-4

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