Chronic Congestive Heart Failure in Infancy and Childhood: New Aspects of Diagnosis and Treatment

Abstract

Congestive heart failure (CHF) is the inability of the heart to meet the metabolic demands of the body. As a disease of the advanced age with a frequency of 1–2% of the population it is rare in infancy and childhood. The incidence ranges from 2.95 (in all US children’s hospitals) to 23.2 (University’s Childrens Hospital Essen) on 1 000 discharges. Among the diagnostic procedures echocardiography is the primary modality of imaging. Tei-index and tissue-Doppler are more sensitive parameters for LV-dysfunction. BNP/NT-proBNP are age-dependent and can guide the long-term therapy. Treatment in childhood does not differ basically from that in adulthood, recommended by several guidelines, but data regarding the various substances – outlined in detail – are very limited. Here a big work has to be done in future!

Zusammenfassung

Von Herzversagen spricht man, wenn das Herz nicht die metabolischen Bedürfnisse des Körpers decken kann. Als eine Erkrankung des höheren Alters mit einer Häufigkeit von 1–2% der Bevölkerung ist sie im Kindesalter selten. Die Inzidenz reicht von 2,95 (bei US-Kinderkliniken) bis 23,2 (Universitäskinderklinik Essen) auf 1 000 Entlassungen. Bei der Diagnostik ist die Echokardiografie die wesentlichste Methode der Bildgebung. Tei-Index und Gewebs-Doppler sind ausgesprochen sensitive Parameter der LV-Dysfunktion. BNP/NT-proBNP sind altersabhängig und können die Langzeittherapie steuern. Die Behandlung im Kindesalter unterscheidet sich nicht wesentlich von der des Erwachsenenalters, wie sie in mehreren Leitlinien empfohlen wird. Dabei ist die Datenlage und damit die Evidenzbasis bei den verschiedenen Substanzen, die im einzelnen ausgeführt werden, schlecht. Hier ist noch viel zu tun!

Key words

congestive heart failure - infancy and childhood - diagnosis - treatment

Schlüsselwörter

Herzversagen - Kindesalter - Diagnostik - Therapie

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