Heart failure in children and adolescents (high yield topics for primary care pediatrician)

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HF in children is a life-threatening polyethiological state with a tendency to progression. There are acute and chronic heart failure, the causes of which are largely determined by age. Depending on the causes and features of hemodynamics, HF can occur with a stored (and borderline) and with a reduced ejection fraction. In early and young childhood, HF is manifested primarily by a decrease in appetite, sweating, decreased physical activity and a slowdown in physical development. At an older age, shortness of breath, edema, and enlargement of the liver are highlighted. The determination of biochemical markers of myocardial insufficiency (natriuretic peptide, troponin) is important for assessing the degree of HF, although the standards for their concentration for different age groups require further refinement. An instrumental study noted a decrease in myocardial contractility. Initially, myocardial oxygen consumption is increasing, which indicates its irrational use and corresponds to increased peroxidation. Subsequently, myocardial oxygen consumption decreases even without signs of coronary pathology. Treatment should include mandatory sufficient calorie intake, sparing regimen, complex drug therapy.

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About the authors

Wassili M. Delyagin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; Scientific and educational biomedical cluster "Translational Medicine"; Peoples' Friendship University of Russia

Author for correspondence.
Email: delyagin-doktor@yandex.ru
ORCID iD: 0000-0001-8149-7669

D. Sci. (Med.), Prof., Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Scientific and educational biomedical cluster "Translational Medicine", Peoples' Friendship University of Russia

Russian Federation, Moscow; Moscow; Moscow

Inna V. Lukjanova

Children's City Polyclinic №130

Email: dgp130-f1@zdrav.mos.ru

Cand. Sci. (Med.), Children's City Polyclinic №130

Russian Federation, Moscow

References

  1. Kumar V, Abbas A, Aster J. Robbins and Cotran Pathology Basis of Disease. 9th Edition. 2015; p. 1408.
  2. Rossano JW, Shaddy RE. Heart failure in children: etiology and treatment. J Pediatr. 2014;165(2):228-33.
  3. Satou G. Pediatric congestive heart failure. Available at: https://emedicine.medscape.com/article/2069746-overview. Accessed: 23.04.2019.
  4. Panesar D, Burch M. Understanding and treating heart failure in children. Symposium: cardiovascular medicine. Pediatric and child health. 2016;27(2):43-9.
  5. Metra M, Felker GM, Zacà V, et al. Acute heart failure: multiple clinical profiles and mechanisms require tailored therapy. Int J Cardiol. 2010;144(2):175-9.
  6. Kurmanil S, Squire I. Acute Heart Failure: Definition, Classification and Epidemiology. Curr Heart Fail Rep. 2017;14(5):385-92.
  7. Illing S, Claβen M. Klinikleitfaden Pädiatrie. 9 Auflage. München. 2014; p. 864.
  8. Rossano JW, Kim JJ, Decker JA, et al. Prevalence, morbidity and mortality of heart failure-related hospitalisations in children in the United States: a population based study. J Card Fail. 2012;18(6):459-70.
  9. Федеральные клинические рекомендации по оказанию медицинской помощи детям с хронической сердечной недостаточностью. М.: Союз педиатров России, 2016 [Federal clinical guidelines for the provision of medical care to children with chronic heart failure. Moscow: Soiuz pediatrov Rossii, 2016 (in Russian)].
  10. Andrews R, Fenton M, Ridout D, Borch M; British congenital cardiac association. New-onset heart failure due to heart muscle disease in childhood: a prospective study in the United Kingdom and Ireland. Circulation. 2000;117(1):79-84.
  11. Andrews R, Fenton M, Dominguez T, Burch M; British congenital cardiac association. Heart failure from heart muscle disease in childhood: a 5–10 year follow‐up study in the UK and Ireland. ESC Heart Failure. 2016;3(2):107-14.
  12. Dipchand A. Current state of pediatric cardiac transplantation. Ann Cardiothorac Surg. 2018;7(1):31-55.
  13. Zile MR, Litwin SE. Heart failure with a preserved ejection fraction. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th Ed. 2019. Philadelphia, PA: Elsevier. 2019; chap 26.
  14. Mann D. Management of Heart Failure Patients with Reduced Ejection Fraction. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th Ed. 2019; p. 490-522e4.
  15. Isaeva LA, Deliagin VM, Bazhenova LK. Main manifestations of carditis in diffuse connective tissue diseases in children. Cor et vasa. 1988;30(3):211-7.
  16. Делягин В.М., Мельникова М.Б., Абраменкова Г.Ф., Волков И.Э. Диабетическая кардиомиопатия и атеросклероз. Болезни сердца и сосудов (актуальные и спорные вопросы). 2009;2:12-7 [Deliagin VM, Melnikova MB, Abramenkova GF, Volkov IE. Diabeticheskaia kardiomiopatiia i ateroskleroz. Bolezni serdtsa i sosudov (aktualnye i spornye voprosy). 2009;2:12-7 (in Russian)].
  17. Делягин В.М., Жакупова Ж.С. Морфометрические и функциональные характеристики миокарда у детей и подростков с синдромом Марфана. Детская больница. 2010;3:30-6 [Deliagin VM, Zhakupova ZhS. Morfometricheskie i funktsionalnye kharakteristiki miokarda u detei i podrostkov s sindromom Marfana. Detskaia bolnitsa. 2010;3:30-6 (in Russian)].
  18. Weintraub RG, Semsarian C, Macdonald P. Dilated cardiomyopathy. Lancet. 2017;390(10092):400-14.
  19. Делягин В.М., Мальцев В.И., Румянцев А.Г. Лекции по клинической диагностике внутренних болезней. К.: МОРИОН, 2007 [Deliagin VM, Maltsev VI, Rumiantsev AG. Lectures on the clinical diagnosis of internal diseases. Kiev: MORION, 2007 (in Russian)].
  20. Falk RH, Hershberger RE. The Dilated, Restrictive and Infiltrative Cardiomyopathies. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th Ed. 2019; p. 1580-601.
  21. Делягин В.М., Румянцев А.Г. Артериальная гипертензия у детей и подростков. М.: ГЭОТАР-Медиа, 2021 [Delyagin VM, Rumiantsev AG. Arterial hypertension in children and adolescents. Moscow: GEOTAR-Media, 2021 (in Russian)].
  22. Dilated cardiomyopathy. Elsevier Point of Care. Available at: https://www.clinicalkey.com/#!/content/clinical_overview/67-s2.0-5da6eed4-d3c6-4ad4-81f7-aa676a2b1229. Accessed: 17.01.2020.
  23. Havaluk O, Rezkalla SH, Kloner RA. The Cardiovascular Effects of Cocaine. J Am Coll Cardiol. 2017;70(1):101-13.
  24. Cameán A, López-Artíguez M, Roca I, et al. Determination of Cobalt, Manganese and Alcohol Content in Beers. J Food Prot. 1998;61(1):129-31.
  25. Packer M. Cobalt Cardiomyopathy. A Critical Reappraisal in Light of a Recent Resurgence. Circ Heart Fail. 2016;9:e003604. doi: 10.1161/CIRCHEARTFAILURE.116.003604
  26. Collins MA, Neafsey EJ, Mukamal KJ, et al. Alcohol in moderation, cardioprotection and neuroprotection: epidemiological considerations and mechanistic studies. Alcohol Clin Exp Res. 2009;33(2):206-19.
  27. Walsh CR, Larson MG, Evans JC, et al. Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study. Ann Intern Med. 2002;136(3):181-91.
  28. Guiraud A, de Lorgelli M, Boucher F, et al. Cardioprotective effect of chronic low dose ethanol drinking: Insights into the concept of ethanol preconditioning. J Mol Cell Cardiol. 2004;36(4):561-6.
  29. Muñoz G, Urrutia JC, Burgos CF, et al. Low concentrations of ethanol protect against synaptotoxicity induced by Aβ in hippocampal neurons. Neurobiol Aging. 2015;36(2):845-56.
  30. Muntwyler J, Hennekens CH, Buring JE, Gaziano JM. Mortality and light to moderate alcohol consumption after myocardial infarction. Lancet. 1998;352(9144):1882-5.
  31. Mostofsky E, Mukamal KJ, Giovannucci EL, et al. Key Findings on Alcohol Consumption and a Variety of Health Outcomes From the Nurses' Health Study. Am J Public Health. 2016;106(9):1586-91.
  32. Inchley J, Currie D, Vieno A, et al. Adolescent alcohol-related behaviours: trends and inequalities in the WHO European Region, 2002–2014. World Health Organization 2018.
  33. Артамонова С.Ю., Саввина А.В., Степанова Л.А. Медико-психологические факторы риска нарушений адаптации подростков-девятиклассников. Современные вопросы педиатрии. Якутск, 03–04 апреля 2014 года. Сборник научных трудов. Киров: Международный центр научно-исследовательских проектов, 2014 [Artamonova SIu, Savvina AV, Stepanova LA. Medical and psychological risk factors for adaptation disorders in ninth-grade adolescents. Modern issues of pediatrics. Yakutsk, 03–04 April 2014. Collection of scientific papers. Kirov: Mezhdunarodnyi tsentr nauchno-issledovatelskikh proektov, 2014 (in Russian)].
  34. Hood WP Jr, Rackley CE, Rolett EL. Wall Stress in the Normal and Hypertrophied Human Left Ventricle. Am J Cardiol. 1968;22(4):550-8.
  35. Graham TP Jr, Covell JW, Sonnenblick EH, et al. Control of Myocardial Oxygen Consumption: Relative Influence of Contractile State and Tension Development. J Clin Invest. 1968;47(2):375-85.
  36. Ratshin RA, Rackley CE, Russel RO. Determination of Left Ventricle Preload and Afterload by quantitative Echocardiography in Men. Circulation Research. 1974;34(5):711-8.
  37. Гасилин В.С., Юренев А.П., Максумов Э.Ю., и др. Возможности определения внутримиокардиального напряжения ЛЖ с помощью эхокардиографии у больных ишемической болезнью сердца. Терапевтический архив. 1979;51(8):18-20 [Gasilin VS, Iurenev AP, Maksumov EIu, et al. Possibilities of determining LV intramyocardial tension using echocardiography in patients with ischemic heart disease. Terapevticheskii Arkhiv (Ter. Arkh.). 1979;51(8):18-20 (in Russian)].
  38. Kristensen ChB, Axelsson J, Greve A, et al. Wall Stress-Mass-Heart Rate Product as an Estimate of Myocardial Oxygen Consumption Predicts Heart Failure in Mild to Moderate Asymptomatic Aortic Stenosis. J Am Coll Cardiol. 2014;63(Suppl. 12):A1956.
  39. Romuk E, Wojciechowska C, Jacheć W, et al. Comparison of Oxidative Stress Parameters in Heart Failure Patients Depending on Ischaemic or Nonischaemic Aetiology. Oxid Med Cell Longev. 2019;2019:7156038. doi: 10.1155/2019/7156038
  40. Schoeffer M, Wallet F, Robert M, et al. Increased Troponin I level in a Duchenne muscular dystrophy patient with normal coronarogaphy. Ann Fr Anesth Reanim. 2008;27(4):345-7.
  41. Schmid J, Luesinger L, Birner-Gruenberger R, et al. Elevated Cardiac Troponin T in Patients with Skeletal Myopathies. J Am Coll Cardiol. 2018;71(14):1540-9.
  42. Ross RD. The Ross classification for heart failure in children after 25 years: A review and an age-stratified revision. Pediatr Cardiol. 2012;33(8):295-300.
  43. Das BB. Current State of Pediatric Heart Failure. Children (Basel). 2018;5(7):88. doi: 10.3390/children5070088
  44. Lantin-Hermoso MR, Berger S, Bhatt AB, et al. The Care of Children with Congenital Heart Disease in Their Primary Medical Home. Pediatrics. 2017;140(5):e20172607. doi: 10.1542/peds.2017-2607
  45. Aydin Sc, Siddiqi N, Janson ChM, et al. Pediatric Heart Failure and Pediatric Cardiomyopathies. Critikal Heart Disease in Infants and Children. 3th Ed. 2019; p. 825-867.e6.
  46. Berliner D, Bauersachs J. Current Drug Therapy in Chronic Heart Failure: the New Guidelines of the European Society of Cardiology (ESC). Korean Circ J. 2017;47(5):543-54.
  47. Friedrich EB, Böhm M. Treatment of Chronic Heart Failure. US Cardiology. 2006;3(1):1-5.
  48. Shrepal J, Balu U. Digoxin in management of heart failure in children: should it be continued ore relegated to history book. Annals of Pediatric Cardiology. 2009;2(2):149-52.
  49. Park MK. Congestive Heart Failure. Park's Pediatric Cardiology for Practitioners. 6th Ed. 2014; p. 451-64.
  50. Rossano JW, Shaddy RE. Heart Failure in Children: Etiology and Treatment. The Journal of Pediatrics. 2014;165(2):228-33. doi: 10.1016/j.jpeds.2014.04.055
  51. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):2440-92.
  52. Kantor P, Lougheed J, Dancea A, et al. Presentation, Diagnosis, and Medical Management of Heart Failure in Children: Canadian Cardiovascular Society Guidelines. Can J Cardiol. 2013;29(12):1535-52.

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2. Fig. 1. Dependence of the duration of the fast filling phase (с) on the duration of the flow of diabetes (years); r=0.5; p<0.0006 (norm – 0.055±0.002 s).

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