Heart Failure with Preserved Ejection Fraction in Children

Authors

Bibhuti Das, Department of Pediatrics, Division of Cardiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA. bdas@umc.edu.
Shriprasad Deshpande, Department of Pediatrics, Children's National Hospital, The George Washington University, Washington, DC, USA.
Jyothsna Akam-Venkata, Department of Pediatrics, Division of Cardiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
Divya Shakti, Department of Pediatrics, Division of Cardiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
William Moskowitz, Department of Pediatrics, Division of Cardiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
Steven E. Lipshultz, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Oishei Children's Hospital, Buffalo, NY, 14203, USA.

Document Type

Journal Article

Publication Date

8-17-2022

Journal

Pediatric cardiology

DOI

10.1007/s00246-022-02960-7

Keywords

Adolescents; Child; Diastolic heart failure; HFpEF: Heart failure with preserved ejection fraction; Pediatric

Abstract

Diastolic dysfunction (DD) refers to abnormalities in the mechanical function of the left ventricle (LV) during diastole. Severe LVDD can cause symptoms and the signs of heart failure (HF) in the setting of normal or near normal LV systolic function and is referred to as diastolic HF or HF with preserved ejection fraction (HFpEF). Pediatric cardiologists have long speculated HFpEF in children with congenital heart disease and cardiomyopathy. However, understanding the risk factors, clinical course, and validated biomarkers predictive of the outcome of HFpEF in children is challenging due to heterogeneous etiologies and overlapping pathophysiological mechanisms. The natural history of HFpEF varies depending upon the patient's age, sex, race, geographic location, nutritional status, biochemical risk factors, underlying heart disease, and genetic-environmental interaction, among other factors. Pediatric onset HFpEF is often not the same disease as in adults. Advances in the noninvasive evaluation of the LV diastolic function by strain, and strain rate analysis with speckle-tracking echocardiography, tissue Doppler imaging, and cardiac magnetic resonance imaging have increased our understanding of the HFpEF in children. This review addresses HFpEF in children and identifies knowledge gaps in the underlying etiologies, pathogenesis, diagnosis, and management, especially compared to adults with HFpEF.

APA Citation

Das, Bibhuti; Deshpande, Shriprasad; Akam-Venkata, Jyothsna; Shakti, Divya; Moskowitz, William; and Lipshultz, Steven E., "Heart Failure with Preserved Ejection Fraction in Children" (2022). GW Authored Works. Paper 1471.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1471

Department

Pediatrics