Understanding the pathophysiology of paediatric heart failure and its treatment

SummaryOver recent years, there have been many advances in the understanding of heart failure, leading to novel approaches to treatment. Predictably, most of this work has taken place in adults, who not only make up the vast majority of heart failure sufferers, but are more commonly enrolled in clinical trials. For the paediatrician and paediatric cardiologist to use this information, certain careful extrapolations must be made. For this reason, it is perhaps even more essential for these physicians to have a thorough knowledge of the basis of these advancements. This consists of a solid grounding in the physiology of the working heart, and an in-depth knowledge of the pathophysiology of the failing heart. It is these two areas, along with the rationale for current and potential future drug therapies, which are covered in this review.