Novel medical therapies for pediatric heart failure

Treatment of pediatric heart failure is challenging because of the heterogeneity in etiology and the lack of extensive, standardized guidelines. Many current treatment regimens are based on anecdotal evidence or experience in adult populations. Mortality rates can be high in children with heart failure, and studies of treatment strategies for improving outcome are ongoing. Newer strategies for pediatric populations may involve optimizing established regimens that have been successful in adults or validating alternative intravenous therapies, such as levosimendan and nesiritide, which have shown promise in early studies. As the technology continues to improve, ventricular assist devices are being used more frequently in children. Studies are underway to evaluate the success of cardiac resynchronization therapy in children with ventricular dyssynchrony. In addition, indirect strategies that target other organ systems may improve cardiac function in a global approach to treating pediatric patients. This article will summarize current therapies and present options for newer treatment strategies for the increasing population of children with heart failure.