Heart Failure Research
Our doctors are pursuing better ways to manage heart failure in children. Our research includes the following.
Approval of Entresto to Treat Heart Failure in Children
Sacubitril/valsartan (Entresto) combines 2 medicines that help control sodium and fluid levels in the body and relax and open the blood vessels. Doctors have used it to treat heart failure in adults for several years. Seattle Children’s took part in a multicenter study testing Entresto for pediatric heart failure. Results of this study led the U.S. Food and Drug Administration (FDA) to fast-track approval of the drug for use in children.
Using Biomarkers to Improve Diagnosis and Treatment
A biomarker is a molecule found in the body that is a sign of a process or condition. When the heart begins to fail, it makes more of the biomarker B-type natriuretic peptides (BNPs). For years, doctors have used a test to measure BNPs in adults with heart problems. This is a quick, inexpensive way to find out if a person’s heart is failing. Our research showed that this test also works in children. Now we are studying if a patient’s BNP levels can predict how they will respond to heart failure treatments.
Studying Health Conditions That May Contribute to Heart Failure
Many children with heart problems also have obstructive sleep apnea, iron and vitamin deficiencies and other health problems. Dr. Yuk Law and his colleagues are studying if these conditions play a part in heart failure or worsen it — and if treatment for them can improve results for children with heart failure.
A New Way to Protect Organs During Surgery
Heart surgery can injure the heart, kidneys and other organs by stopping blood from flowing to them for a short time. Law and his colleagues are studying if a method called remote ischemic preconditioning can reduce this injury. It involves restricting blood flow to a leg or other body part right before surgery. This sends the organs a signal that blood flow is about to stop and gives them a chance to prepare. The investigators have seen some degree of kidney protection and are considering the next step.
Seeking to Detect Organ Rejection Earlier
In children who have a heart transplant, organ rejection is fairly common. It happens if the child’s immune system attacks and injures their new heart. It’s important to detect rejection early because this helps us treat it. Our researchers are studying ways to improve early detection. These include using unique echocardiography measurements, biomarkers and an app to track heart-rate changes that could signal rejection.
We are also working with immunologists to better understand why some transplant patients never have organ rejection while other patients do.
Understanding Heart Failure in Fontan Patients
The Fontan procedure is surgery to send blue (oxygen-poor) blood from the body to the lungs without going through the right ventricle of the heart. This may be done for children whose heart valves or ventricles did not form normally. Our researchers are creating a registry and collecting tissue samples to study so we can learn how and why heart failure happens in some patients who had this surgery.
Investigating Ways to Prevent Sudden Cardiac Death
Dr. Jack Salerno is working to prevent deaths from sudden, unexpected cardiac arrest. Salerno partners with the Nick of Time Foundation to do heart screenings in high schools. These tests help doctors and families know if a child might have a heart problem and needs to see a heart doctor.
Salerno also uses the screenings to gather details about children’s hearts. The details will help him understand more about factors that put children at risk of sudden cardiac death and find ways to prevent cardiac arrest. Cardiomyopathy is 1 of several heart conditions that increases risk for sudden cardiac arrest and death. It can also lead to heart failure.
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