Challenges in managing pediatric heart failure, especially in resource-limited settings.

The sacubitril/valsartan group showed a trend of greater reductions in NT-proBNP levels, though this difference was not statistically significant.[ 28 ] Other researchers also hint that ARNIs may not reduce composite endpoints of mortality or transplant within 1 year.[ 29 ] More importantly, their use may not be well tolerated across the spectrum of pediatric HF.[ 19 ] Sodium–glucose cotransporter-2 inhibitors Dapagliflozin and empagliflozin, selective renal SGLT2 inhibitors, appear to have direct cardiovascular benefits.

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