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Prognostic features in childhood idiopathic dilated cardiomyopathy

Published online by Cambridge University Press:  19 August 2008

Karen S. Rheuban*
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia, USA
Donna Cregan-Lambert
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia, USA
Howard P. Gutgesell
Affiliation:
University of Virginia Health Sciences Center, Charlottesville, Virginia, USA
*
Karen S. Rheuban, M.D. University of Virginia Health Sciences Center, Divison of Pediatric Cardiology, Box 386. Charlottesville, Virginia 22908. Tel: 804-924-2481; Fax 804-982-1415

Abstract

The clinical course, noninvasive findings and outcome of 25 infants and children with idiopathic dilated cardiomyopathy were reviewed retrospectively to identify factors predictive of outcome both at diagnosis and at short-term follow-up. Patients, stratified by clinical status at last visit, were assigned to groups encompassing those who were asymptomatic and receiving on medication, those patients who were symptomatic or needed medication to control symptoms, and those who were dead, awaiting heart transplantation, or had undergone transplantation. Older age at diagnosis was strongly associated with poor clinical outcome (p=0.005), as was the presence of arrhythmias at the time of diagnosis (p=0.008) and at short-term follow-up-(p=0.003). Echocardiographic studies at diagnosis failed to predict eventual clinical outcome, although patients who ultimately recovered and did not need medications tended to demonstrate improvement in or resolution of echocardiographic abnormalities within 6 months of diagnosis.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1997

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References

1Griffin, MI, Hernandez, A, Martin, TC, Goldring, D, Bolman, RM, Spray, TL. Dilated cardiomyopathy in infants and children. J Armer Coll Cardiol 1988; 11: 139144.CrossRefGoogle ScholarPubMed
2Wiles, HB, McArthur, PD, Taylor, AB, Gillette, PC, Fyfe, DA, Matthews, JP, Shelton, LW. Prognostic features of childern with dilated cardiomyopathy. Amer J Cardiol 1991; 68: 13721376.CrossRefGoogle Scholar
3Taliercio, CP, Seward, J, Driscoll, D, Fisher, L, Gersh, B, Tajik, AJ. Idiopathic dilated cardiomyopathy in the young: a clinical profile and natural history. J Amer Coll Cardiol 1985; 6: 11261131.CrossRefGoogle Scholar
4Lewis, AB, Chabot, M. Outcome of infants and children with dilated cardiomyopathy. Amer Heart J 1991; 68: 365369.Google ScholarPubMed
5Miller, LW, Schlant, RC, Kobashigawa, J, Kubo, S, Renlund, DG. Complications, 24th Bethesda Conference: Cardiac Transplantation. J Amer Coll Cardiol 1993; 22: 4154.CrossRefGoogle ScholarPubMed
6Gutgesell, HP, Paquet, M, Duff, DF, McNamara, DG. Evaluation of left ventricular size and function by echocardiography. Circulation 1977; 56: 457462.CrossRefGoogle ScholarPubMed
7Carvalho, JS, Silva, CMC, Shinebourne, EA, Redington, A. Can M-mode derived indices of left ventricular function and wall thickeness in dilated cardiomyopathy/myocarditis predict outcome? Cardiology in the Young 1993; 3: 130.Google Scholar
8Rowland, DG, Gutgesell, HP. Use of mean arterial blood pressure for noninvasive determination of left ventricular end-systolic wall stress in infants and children. Amer J Cardiol 1994; 74: 9899.CrossRefGoogle ScholarPubMed
9Grossman, W, Jones, D, McLaurin, LP. Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest 1975; 56: 5664.CrossRefGoogle ScholarPubMed
10Borow, KM, Green, LH, Grossman, W, Braunwald, E. Left ventricular end-systolic stress shortening and stress length relations in humans. Amer J Cardiol 1982; 50: 13011308.CrossRefGoogle Scholar
11Devereaux, RB, Alonso, DR, Lutas, EM, Gottlieb, GJ, Campo, E, Sachs, I, Reichek, N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Amer J Cardiol 1986; 57: 450458.CrossRefGoogle Scholar
12Daniels, DD, Meyer, RA, Liang, Y, Bove, KE. Echocardiography determined left ventricular mass index in normal children, adolescents, and young adults. J Amer Coll Cardiol 1988; 12: 703708.CrossRefGoogle ScholarPubMed
13Agaki, T, Benson, LN, Lightfoot, NE, Chin, K, Wilson, G, Freedom, RM. Natural history of dilated cardiomyopathy in children. Amer Heart J 1991; 121: 1502CrossRefGoogle Scholar
14Chen, SC, Nouri, S, Balfour, I, Jureidini, S, Appleton, RS. Clinical profile of congestive cardiomyopathy in children. J Amer Coll Cardiol 1990; 15: 189193.CrossRefGoogle ScholarPubMed
15Friedman, RA, Moak, JP, Garson, A. Clinical course of idiopathic dilated cardiomyopathy in children. J Amer Coll Cardiol 1991; 18: 152156.CrossRefGoogle ScholarPubMed
16Gersony, WM. The child with dilated cardiomyopathy: Prognostic considerations and management decisions. J Amer Coll Cardiol 1991; 18: 157158.CrossRefGoogle ScholarPubMed
17Benjamin, IJ, Schuster, EH, Bulkley, BH. Cardiac hypertrophy in idiopathic dilated congestive cardiomyopathy: a clinicipathologic study. Circulation 1981; 64: 442447.CrossRefGoogle Scholar
18Borow, K. An integrated approach to the noninvasive assessment of left ventricular systolic and diastolic performance, In: StJohn Sutton, M. ed. Textbook of Adult and pediatric Echocardiography and Doppler, Blackwell Scientific Publications, Boston, 1989;97155.Google Scholar
19Kimball, TR, Daniels, SR, Meyer, RA, Schwartz, DC, Kaplan, S. Left ventricular mass in childhood dilated cardiomyopathy: a possible predictor for selection of patients for cardiac transplantation. Amer Heart J 1991; 122: 126131.CrossRefGoogle ScholarPubMed