Journal of Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2433-1783 Print ISSN: 2433-2720
Japanese Society of Pediatric Cardiology and Cardiac Surgery
Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Journal of Pediatric Cardiology and Cardiac Surgery 3(2): 63-79 (2019)
doi:10.24509/jpccs.190201

ReviewReview

Recognition and Management of Preclinical Cardiomyopathies in Children: Special Focus on Duchenne Muscular Dystrophy and Anthracycline Cardiotoxicity

Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children ◇ Wilmington, DE 19803, USA

受付日:2019年3月20日Received: March 20, 2019
受理日:2019年5月17日Accepted: May 17, 2019
発行日:2019年7月1日Published: July 1, 2019
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Heart failure is conventionally defined as a dynamic clinical syndrome where the cardiovascular system fails to meet the metabolic demand of the peripheral tissues or can only do so at the expense of increased ventricular filling pressure. Emerging new findings in biomedical research have enabled us to recognize the early preclinical myocardial changes at the cellular and molecular levels before ventricular dysfunction becomes visible. These preclinical changes have also become recognizable by advanced medical technology. Here, we introduce two relatively common clinical entities that present with an asymptomatic preclinical stage in pediatrics, cardiomyopathies in Duchenne muscular dystrophy and anthracycline-induced cardiotoxicity. We will discuss underlying pathobiology, early diagnosis by noninvasive imaging studies, and cardioprotective treatment of the preclinical stage of progressive myocardial disease. The early recognition and treatment of the preclinical stage of heart failure may provide us with new perspectives in understanding this devastating disease.

Key words: preclinical heart failure; noninvasive imaging; cardiomyopathy; muscular dystrophy; cardio-oncology

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