Clinical Challenges in Management of Pediatric Cardiomyopathy

Dear Colleagues,

Pediatric cardiomyopathies are a heterogenous group of rare disorders, characterized by mechanical and electrical abnormalities of the heart muscle with an annual incidence of 1.1 to 1.5 per 100,000. This disease may be related to coronary artery abnormalities, tachyarrhythmias, exposure to infection or toxins, or secondary to other underlying disorders. The study of pediatric cardiomyopathies offers important insights into pathogenesis of myocardial dysfunction in the absence of confounding comorbidities common in adults. As a chronic disease, pediatric cardiomyopathy requires a comprehensive treatment approach and a multidisciplinary chronic disease program approach in order to improve long-term outcomes. To date, therapeutic options vary from medical management to ventricular assist devices and heart transplantation, if pharmaceutical therapies are ineffective. Medical therapy used in adults has been applied to children with cardiomyopathies but with varying degrees of success. However, differences in etiologies, pharmacodynamics, duration of therapy and therapeutic goals between children and adults with cardiomyopathies require additional studies to clarify the efficacy and value of medical therapy in children. Moreover, the use of mechanical support to bridge patients to heart transplantation is increasing, because of an increasing number of children with cardiomyopathy being listed with an increasing wait time. Heart transplantation remains the mainstay and is reserved for advanced and extreme cases with favorable prognosis. Individual therapeutic regimens due to pediatric characteristics may improve the effects of treatment and patient survival. The published literature in the field of pediatric cardiomyopathies ranges from large registry epidemiological outcome and risk factor analyses to individual case reports. We encourage you and your co-workers to submit your articles reporting on this topic. We warmly invite you to submit articles and reviews reporting on evidence and expectations from innovative therapy, with a special focus on individualized approaches.

Dr. Gianluigi Perri
Dr. Lorenzo Galletti
Guest Editors

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• pediatric cardiomyopathy
• pediatric heart failure
• ventricular assist device
• heart transplantation
• mechanical circulatory support