the Clinical Outcome of Empagliflozin in Pediatric Heart Failure Patients

Inclusion Criteria: * • Pediatrics (aged 1months-18 years) * Confirmed HF diagnosis: HF will be defined by reduced ventricular systolic function (left ventricular ejection fraction by echocardiography) or impaired ventricular filling (pulmonary capillary wedge pressure \> 18 mmHg measured directly and/or the ratio of early diastolic mitral inflow velocity(E) to early diastolic mitral annular velocity (e')( E/e'\>14 by echocardiography) with clinical features of congestion and/or low cardiac output. • Class III or IV of ROSS classification or BNP level more than 300 pg/mL Exclusion Criteria: * • Pediatric with chronic kidney failure * Avoid initiating empagliflozin in patients with concurrent urinary tract infection (UTI). * patients with eGFR \<60 mL/minute/1.73 m2 will be excluded. * Patients with contraindication to empagliflozin usage which include * eGFR \<30 mL/minute/1.73 m2 * Hypersensitivity (eg, angioedema) to empagliflozin