Chronic heart failure management in adult patients with congenital heart disease.

Autor: Dhingra NK; Division of Cardiac Surgery., Mazer CD; Department of Anesthesia.; Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada., Connelly KA; Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Canada.; Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada., Verma S; Division of Cardiac Surgery.
Jazyk: angličtina
Zdroj: Current opinion in cardiology [Curr Opin Cardiol] 2023 Mar 01; Vol. 38 (2), pp. 82-87. Date of Electronic Publication: 2023 Jan 19.
DOI: 10.1097/HCO.0000000000001011
Abstrakt: Purpose of Review: A growing number of adult patients with congenital heart disease (ACHD) are entering the healthcare system as a result of advances in the diagnosis and management of congenital heart defects. Heart failure is a common final pathway for this diverse patient population, representing the leading cause of mortality in ACHD patients. Herein, we review present guideline-directed management of heart failure in ACHD patients.
Recent Findings: There exists a dearth of data to guide management of ACHD-related heart failure. Given this gap, recent guidelines have been limited in the recommendations they can provide for this patient population, with practitioners being consequently forced to generalize findings from studies of acquired heart disease patients based on mechanistic plausibility. The small number of studies directly assessing ACHD patients have been largely limited in their clinical relevance through being negative, small, observational, limited to specific subsets of ACHD patients or assessing nonvalidated outcomes.
Summary: Despite the prevalence and impact of ACHD-related heart failure, there are limited evidence-based therapies for its management. Given the rising burden of this clinical problem, definitive trials assessing newer therapies are required to establish their potential role in heart failure amongst ACHD patients.
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Databáze: MEDLINE