摘要Background Heart failure(HF)significantly impacts the cardiovascular health of children and adolescents.This study aims to assess epidemiologic trends in HF across sex,age,region,and time period.Methods The number and age-standardized rate(ASR)of prevalence and years lived with disability(YLDs)were derived from the Global Burden of Disease Study 2019.We applied descriptive estimates,correlation analysis,and joinpoint linear regression to determine the trends in HF burden and its etiologies across different dimensions.Results Globally,the number of children and adolescent HF patients exceeded 640,000 in 2019.A positive association was found between sociodemographic index(SDI)levels and HF burden,with higher SDI regions showing the greatest impact,especially in the 15-19-year-old group.The prevalence declined from 57.86 per 100,000 in 1990 to 56.17 in 2019,and YLDs decreased from 5.35 to 5.20 per 100,000 over the same period.Temporal burden trends varied among different SDI regions in the first two decades.Overall,children under 10 years old suffered a heavier burden and presented a more evident increasing trend compared to those aged 10-19 years.Males had a more severe HF burden than females across most regions,age groups,and underlying diseases.When exploring HF-related causes,congenital birth defects,cardiomyopathy and myocarditis were the most common etiologies of cardiac dysfunction.Conclusion Prompt and effective implementation of preventive and management policies worldwide among children and adolescents aged 0-19 years is a top priority to help curb the increasing burden of HF.