Volume 8 – ISHLT Guidelines for the Management of Pediatric Heart Failure

Published: April 2014


Editors: Richard Kirk, MA FRCP, FRCPCH; Anne I. Dipchand, MD, FRCPC; David N. Rosenthal, MD; James K. Kirklin, MD

Contributors (PDF)

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Table of Contents

Chapter 1 Introduction
1.1. Preamble
1.2. Writing Committee & Editorial Process
1.3. Methodology and Evidence Review
1.4. Document Review and Approval
1.5. Conflict of Interest & Financial Support

Chapter 2 Definition of Heart Failure
2.1. Heart Failure Severity
2.2. Disease Staging

Chapter 3 Epidemiology, Natural History and Prognosis of Heart Failure
3.1. Introduction
3.2. Heart Failure with Cardiomyopathy
3.3. Heart Failure due to Congenital Heart Disease
3.4. Heart Failure from Acquired Heart Disease

Chapter 4 Etiology and Pathophysiology of Heart Failure
4.1. Myocyte Structure and Contractility
4.2. Systolic Heart Failure
4.3. Diastolic Heart Failure
4.4. Biventricular Interactions in Heart Failure
4.5. Clinical Manifestations of Heart Failure
4.6. Genetics of Cardiomyopathy
4.7. Heart failure in Congenital Heart Disease

Chapter 5 Diagnostic Approach to Pediatric Heart Failure
5.1. Diagnostic Tests
5.2. B-type Natriuretic Peptide
5.3. Cardiac Imaging
5.4. Role of Exercise Testing
5.5. Sleep study
5.6. Ambulatory Electrocardiographic Monitoring
5.7. Cardiac Catheterization and Endomyocardial Biopsy
5.8. Assessment of pulmonary vascular resistance
5.9. Invasive Electrophysiologic Testing

Chapter 6 Pharmacological Treatment of Chronic Heart Failure with Reduced EF (systolic heart failure)
6.1. Diuretics
6.2. Angiotensin-converting enzyme inhibitors
6.3. Beta-blockers
6.4. Mineralocorticoid/aldosterone receptor antagonists
6.5. Angiotensin receptor blockers
6.6. Ivabradine
6.7. Digoxin and Other Digitalis Glycosides
6.8. Combination of Hydralizine and Isosorbide Dinitrate
6.9. Antiarrhythmics Medications
6.10. 3 Hydroxy-3-methylglutaryl-coenzyme A Reductase Inhibitors ('statins')
6.11. Renin inhibitors
6.12. Anticoagulants
6.13. Nesiritide
6.14. Pulse or Chronic Inotropic Support (other than as bridge to transplant or palliation)
6.15. Vasopressin Receptor Antagonists
6.16. Stem Cell Therapy
6.17. Stage A Heart Failure

Chapter 7 Pharmacological Treatment of Heart Failure with 'Preserved' EF (diastolic heart failure)
7.1. Therapies with Class I Indications (including any with II and III indications as well)
7.2. Therapies with Class II Indications
7.3. Therapies with Class III Indications

Chapter 8 Electrophysiology in Heart Failure
8.1. Pacemaker Therapy
8.2. Cardiac Resynchronization
8.3. Implantable cardioverter defibrillator therapy
8.4. Ablation Therapy

Chapter 9 Device Treatment of Pediatric Heart Failure
9.1. Overview of Mechanical Circulatory Support
9.2. Durable Mechanical Circulatory Support
9.3. Temporary Mechanical Circulatory Support
9.4. Special Topics
9.5. Future Directions

Chapter 10 Co-morbidities
10.1. Anemia
10.2. Renal Dysfunction
10.3. Airway and Parenchymal Respiratory Morbidity
10.4. Infectious Diseases in Heart Failure
10.5. Malnutrition and Cachexia
10.6. Metabolic Syndrome
10.7. Depression and Psychological Functioning in Pediatric Heart Failure
10.8. Cognitive and Psychosocial Performance in Pediatric Heart Failure
10.9. Exercise Training and Activity Recommendations

Chapter 11 Acute Heart Failure
11.1. Definition, Etiology and Epidemiology
11.2. Initial assessment
11.3. Monitoring
11.4. Evaluation After Stabilization
11.5. Treatment of Acute Heart Failure
11.6. Fluid Management
11.7. Nutrition
11.8. Considerations in the Treatment of Acute Right Heart Failure
11.9. Perioperative Acute Heart Failure

Chapter 12 Special Patient Populations
12.1. Secondary Right Ventricular Failure
12.2. Systemic Right Ventricular Failure in a Biventricular Circulation
12. 3. Single Ventricle Heart Failure
12.4. Neuromuscular Disorders
12.5. Cancer and Heart Failure

Chapter 13 Transplantation
13.1. Indications and Referral
13.2. Evaluation Process
13.3. Specific Risk Factors
13.4. Pre-transplant Risk Prediction
13.5. Indications for Heart Transplantation
13.6. Overall Outcomes
13.7. Heart Failure Post Transplant
13.8. Re-Transplantation

Chapter 14 Health Care Delivery
14.1. Overview
14.2. Disease Management Systems
14.3. Transition from Pediatric to Adult Care
14.4. Palliative Care & End of Life Support
14.5. Standardization of Practice Guidelines