Abstract:
Pediatric heart failure is a rare but highly morbid condition that can have a huge impact on a child’s long term survival. Given the rarity of pediatric heart transplantation, medical management of pediatric heart failure is vital to improving outcomes in this fragile patient population. Much of the medical therapies to treat pediatric heart failure are extrapolated from adult clinical trials but given the paucity of large scale, multi-center prospective studies in pediatric heart failure, it is up to the clinician to consider use of newer heart failure medications. Our center’s philosophy is to treat pediatric heart with all guideline directed medical therapies (GDMT), and we embarked on utilizing sodium glucose co-transport 2 inhibitors (SGLT2i) since 2020. Since that time, our center has amassed the largest experience of using SGLT2i in pediatric heart failure patients, both congenital heart disease and cardiomyopathy, with low adverse events and improved clinical outcomes including improved functional status, biomarkers, and echocardiographic parameters of systolic function. We concluded that SGLT2i, when added to a background of guideline-directed medical therapy, appears well tolerated in children with heart failure.
