Clinical research directions in pediatric cardiology

Abstract

Clinical research in pediatric cardiology is under-appreciated and under-funded, yet it has enormous implications for cardiovascular health and healthcare over the entire life-course. Renewed interest in federally funded clinical research makes it timely to propose a comprehensive research agenda that, with its associated rationale, will attract public funds for research into child cardiovascular health and disease. We propose here a comprehensive pediatric cardiology research agenda consisting of 22 topics and associated research questions. We describe the following five topics in more detail: the need for life-course studies of pediatric cardiac disease and epigenetic factors for later onset of cardiovascular effects; the need to study cardiometabolic disease risk in children; recent pediatric cardiology clinical trials and observational studies; the need to explore the role of physical activity in preventing and treating pediatric cardiology patients; and the need to develop and implement evidence-based interventions to manage pediatric cardiovascular problems. If the field of pediatric cardiology can adopt a comprehensive research agenda that identifies the most-needed studies, then research could be better coordinated, long-term and collaborative studies would be more readily organized and funded, and the overall financial and scientific efficiency of research in pediatric cardiology would be improved. Targeted research efforts are more likely to realize potential breakthroughs in areas such as genetic and epigenetic screening, biomarkers, cardioprotective strategies, life-course studies, long-term monitoring technologies, environmental influences on disease, evidence-based practice guidelines, and more rapid and safer development of drugs.