Heart failure in the adult patient with congenital heart disease

Abstract

Adults with congenital heart disease are an anatomically heterogeneous group and account for a small percentage of cardiological patients. The underlying causes of haemodynamic derangements in these patients may be either left or right ventricular dysfunction. Pulmonary hypertension is of no less importance. For this reason it is currently impossible to formulate a definition of heart failure in this population. There have been numerous efforts aimed at establishing the role of particular chambers of the heart in heart dysfunction. However, it seems more feasible to focus on systemic neurohormonal stimulation and in the future on the genetic factors responsible for decreased heart performance. Lack of guidelines for heart failure treatment in this subpopulation of patients is a logical consequence of the current level of knowledge. Further research is necessary in order to confirm the efficacy of the pharmacological agents currently recommended in the general population of heart failure patients. (Cardiol J 2007; 14: 127-136)