Document Detail

Applying heart failure guidelines to adult congenital heart disease patients.
MedLine Citation:
PMID:  18248271     Owner:  NLM     Status:  MEDLINE    
There is a growing population of adult patients with congenital heart defects in the developed world. Most have been repaired, but few have been cured. Many have myocardial dysfunction. Most have exercise intolerance. Some have heart failure. As a group, they show neurohormonal activation similar to that seen in an adult heart failure population with acquired heart disease. Currently, the patients at greatest risk of heart failure are those without a systemic left ventricle, such as Mustard and Senning repairs of transposition of the great arteries (TGA), congenitally corrected TGA, and patients who have had a Fontan procedure. Exercise intolerance may predict hospitalization and death in such patients. For those patients with systemic left ventricles, it would seem reasonable to use the heart failure guidelines developed for patients with acquired heart disease. For those patients without a systemic left ventricle (e.g., a systemic right ventricle or single ventricle), there is currently no foundation for evidence-based therapy.
Robert E Shaddy; Gary Webb
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  6     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-05     Completed Date:  2008-03-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  165-74     Citation Subset:  IM    
Division of Cardiology, The Children's Hospital of Philadelphia, and University of Pennsylvania School of Medicine, 34th Street and Civic Center Blvd, Philadelphia, PA 19104-4399, USA.
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MeSH Terms
Biological Markers / metabolism
Cardiovascular System / physiopathology
Heart Defects, Congenital / complications,  physiopathology,  therapy*
Heart Failure / etiology,  therapy*
Heart Ventricles / abnormalities
Neurotransmitter Agents / metabolism
Practice Guidelines as Topic*
Ventricular Function
Reg. No./Substance:
0/Biological Markers; 0/Neurotransmitter Agents

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