Japanese Nationwide Survey of New Heart Failure Drug Prescriptions by Pediatric Cardiologists

Background: This nationwide survey investigated new heart failure drug prescriptions by Japanese pediatric cardiologists. Methods and Results: Among 97 responding institutions, 357 patients received sodium-glucose cotransporter-2 inhibitors (SGLT-2i; n=189), angiotensin receptor-neprilysin inhibitors (ARNI; n=89), selective hyperpolarization-activated cyclic nucleotide-gated channel (HCN) blockers (n=76), or soluble guanylate cyclase (sGC) stimulators (n=3). SGLT-2i were predominantly prescribed in post-Fontan patients (45%), with one-third being children under 18 years. ARNI were commonly used for biventricular congenital heart disease (CHD) and cardiomyopathy (47% and 29%), with 40% under 18 years. Conclusions: Pediatric-specific clinical trials and appropriate usage guidelines are urgently needed.