Pathophysiology and clinical presentation of paediatric heart failure related to congenital heart disease

Spaziani, Gaia; Bennati, Elena; Marrone, Chiara; Lucà, Fabiana; Iorio, Annamaria; Rao, Carmelo Massimiliano; Fusco, Stefania Angela Di; Russo, Maria Giovanna; Colivicchi, Furio; Gabrielli, Domenico; Santoro, Giuseppe; Favilli, Silvia; Gulizia, Michele Massimo

doi:10.1111/apa.15904

Cited by 3 publications

(7 citation statements)

References 59 publications

(103 reference statements)

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“…Studies were included if they had caregivers who cared for a child with a diagnosis of HF in the home or hospital setting. Chronic HF is defined as a clinical and pathophysiologic syndrome resulting from ventricular dysfunction (systolic or diastolic), with characteristic signs and symptoms (poor growth, feeding difficulties, respiratory distress, exercise intolerance, and fatigue, and is associated with circulatory, neurohormonal, and molecular abnormalities) 2 that have very limited surgical option for correction (e.g., cardiac mechanical assist device (VAD) or transplant). A caregiver is defined as a biological caregiver, relative or guardian over 18 years of age who is primarily responsible for the daily management of a child between the ages of 0-21 diagnosed with chronic HF by a pediatric cardiologist.…”

Section: Methodsmentioning

confidence: 99%

“…Heart failure (HF) in children is documented to be a complex and burdensome disease. [1][2][3][4][5] Hospitalizations in the United States are estimated to occur in 11,000-14000 children annually. 1 Adult HF is better characterized as limited data on incidence and prevalence exists in childhood HF due to small numbers, varying phenotypes, and lack of an overall standardized definition.…”

Section: Introductionmentioning

confidence: 99%

“…1 Adult HF is better characterized as limited data on incidence and prevalence exists in childhood HF due to small numbers, varying phenotypes, and lack of an overall standardized definition. 2 It is broadly defined as a clinical and pathophysiological syndrome resulting from ventricular dysfunction, volume or pressure overload, in combination or alone. 7 The cardinal symptoms of children with HF, no matter the etiology, are poor growth, dyspnea, and anasarca.…”

Section: Introductionmentioning

confidence: 99%

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A Qualitative Evidence Synthesis Exploring Caregiver Information Needs and Experiences Caring for a Child with Chronic Heart Failure

Cunningham,

Schroeder,

Plesuk

et al. 2024

Preprint

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Aim: To synthesize qualitative studies relating to caregivers' information needs and experiences caring for a child with chronic heart failure. Background: Children with chronic heart failure (HF) place a considerable burden on healthcare systems each year and is associated with significant stress for caregivers. Despite substantial knowledge generation and implementation amongst healthcare providers in this field, knowledge translation strategies that target caregiver audiences have lagged. To date, little is known about what literature exists about caregiver's information needs and experiences caring for a child with HF. Design: Qualitative evidence synthesis Methods: Sandelowski and Barroso's Handbook for Synthesizing Qualitative Research guided our review, cross-referencing the ENTREQ statement to report our findings. With librarian guidance, seven databases were searched in November 2023. Search results were imported into Microsoft Excel from EndNote 21. Two independent reviewers (CC, KS), supervised by a senior author (SDS), conducted the initial title/abstract and secondary full-text screens. Results: One study met the inclusion criteria outlined in our synthesis, identifying three themes and ten subthemes. Our findings impeded the ability to conduct any analysis. Conclusion: This review was the first of its kind, looking to synthesize caregiver's information needs and experiences caring for a child with chronic HF. One article met the inclusion criteria. This synthesis highlights a significant knowledge gap in caregivers' experiences and information needs when caring for a child affected by chronic heart failure. This study emphasizes that previous educational tools were not designed using research evidence about parent experience. This also validates the critical need for qualitative interviews with parents about their information needs and experiences to provide more relevant and understandable information to parents in this difficult situation.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Qualitative Evidence Synthesis Exploring Caregiver Information Needs and Experiences Caring for a Child with Chronic Heart Failure

Cunningham,

Schroeder,

Plesuk

et al. 2024

Preprint

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“…Importantly, whilst these children may experience significant comorbidities secondary to congestive heart failure, their ventricular function is usually well preserved, and they will make a good recovery post-surgical repair. 3…”

Section: Pulmonary Over-perfusionmentioning

confidence: 99%

Paediatric heart failure – understanding the pathophysiology and the current role of cardiac biomarkers in clinical practice

et al. 2023

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Introduction: Paediatric heart failure is a common clinical syndrome that may be experienced by children with congenital heart disease (CHD) and/or cardiomyopathy. It is characterised by clinical signs/symptoms which reflect the underlying pathophysiology based on one of three main clinical states: Pulmonary over-circulation, pressure overload, and ventricular failure. Current diagnosis relies on clinical assessment and echocardiogram imaging as cardiac biomarkers has been predominantly scientific to date. This review provides a comprehensive overview of paediatric heart failure pathophysiology and considers the available evidence for cardiac biomarkers in this setting. Methods: A literature review was completed using MEDLINE ALL, EMBASE, and PubMed on 10th November, 2022. Search terms included biomarkers, heart failure, heart defects, congenital heart disease, fontan circulation, single ventricle circulation, cardiomyopathy, and child. This allowed the identification of individual cardiac biomarkers which are the focus of this review. These included NT-proBNP, MR-proANP, MR-proADM, troponin, sST2, galectin 3, and growth differentiation factor-15. Results: Paediatric studies have established reference ranges for NT-proBNP and troponin for children with structurally normal hearts. Of all the biomarkers reviewed, NT-proBNP appears to correlate most closely with symptoms of heart failure and ventricular dysfunction on echocardiogram. However, there remains limited longitudinal data for NT-proBNP, and no validated reference ranges for patients with CHD and/or cardiomyopathy. None of the other biomarkers reviewed were consistently superior to NT-proBNP. Conclusion: Further large paediatric studies of patients with heart failure are needed to validate NT-proBNP in CHD and to evaluate the role of novel biomarkers in specific types of CHD, e.g. single ventricle physiology.

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“…According to The International Society for Heart and Lung Transplantation, pediatric HF can be defined as both a clinical and pathophysiological syndrome initiated by insufficiency of the ventricle and volume or pressure overload, either alone, or a mixture of both ( 32 ). Since pediatric HF has several different triggers, it has a variety of clinical presentations and symptoms that also depend on the age of the patient ( 10 , 33 , 34 ). In infants, the earliest clinical manifestations are usually subtle and typically present with feeding difficulties due to a baseline dyspnea ( 35 ).…”

Section: Definition and Classification Of Pediatric Hfmentioning

confidence: 99%

Insights and perspectives into clinical biomarker discovery in pediatric heart failure and congenital heart disease—a narrative review

Liem¹,

Cadeiras²,

Setty³

2023

Cardiovasc Diagn Ther

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Background and Objective: Heart failure (HF) in the pediatric population is a multi-factorial process with a wide spectrum of etiologies and clinical manifestations, that are distinct from the adult HF population, with congenital heart disease (CHD) as the most common cause. CHD has high morbidity/mortality with nearly 60% developing HF during the first 12 months of life. Hence, early discovery and diagnosis of CHD in neonates is pivotal. Plasma B-type natriuretic peptide (BNP) is an increasingly popular clinical marker in pediatric HF, however, in contrast to adult HF, it is not yet included in pediatric HF guidelines and there is no standardized reference cut-off value. We explore the current trends and prospects of biomarkers in pediatric HF, including CHD that can aid in diagnosis and management.Methods: As a narrative review, we will analyze biomarkers with respect to diagnosis and monitoring in specific anatomical types of CHD in the pediatric population considering all English PubMed publications till June 2022.

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Pathophysiology and clinical presentation of paediatric heart failure related to congenital heart disease

Cited by 3 publications

References 59 publications

A Qualitative Evidence Synthesis Exploring Caregiver Information Needs and Experiences Caring for a Child with Chronic Heart Failure

A Qualitative Evidence Synthesis Exploring Caregiver Information Needs and Experiences Caring for a Child with Chronic Heart Failure

Paediatric heart failure – understanding the pathophysiology and the current role of cardiac biomarkers in clinical practice

Insights and perspectives into clinical biomarker discovery in pediatric heart failure and congenital heart disease—a narrative review

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