Excerpt

Heart failure in the young is a common clinical entity that has significant morbidity and mortality and carries substantial long-term social and financial costs. The leading cause is congenital heart disease, which is the most common birth defect and is also the fifth ranked cause of years of potential life lost, at 2 per 1000 population [1, 2, 6, 21]. Well over 450,000 children [21] and over 1 million adults [12] in the United States have a congenital heart defect, emphasizing its impact on public health. Despite the importance of heart failure in children and infants, it has been less well studied when compared with the rich literature and basic understanding of heart failure in adults. As a result, therapy for children with heart failure has advanced more slowly. Indeed, most new concepts for management of heart failure in children today are based on the translation of adult treatment strategies with little preclinical evidence supporting their use in the young [7, 9]. However, recent and exciting discoveries in the molecular regulation of cardiac morphogenesis, as well as in the cellular and molecular response of the heart to injury, have provided new tools to understand heart failure in the young. …