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Improved outcomes of pediatric dilated cardiomyopathy with utilization of heart transplantation

Anna E Tsirka1, Kathryn Trinkaus, Su-Chiung Chen

  • 1Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.

Journal of the American College of Cardiology
|July 21, 2004
PubMed

Insights

Outcomes for pediatric dilated cardiomyopathy (DCM) vary, with recovery being most common. Heart transplantation significantly improves survival rates for these young patients.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Medical Outcomes Research

Background:

  • Pediatric dilated cardiomyopathy (DCM) has a high mortality rate, with 50-60% of patients dying within five years.
  • The long-term effects of heart transplantation and novel treatments on pediatric DCM outcomes remain unclear.

Purpose of the Study:

  • To investigate the outcomes of pediatric patients diagnosed with dilated cardiomyopathy (DCM).
  • To analyze the relationship between epidemiologic and echocardiographic variables and patient outcomes in pediatric DCM.

Main Methods:

  • Retrospective study of 91 pediatric patients diagnosed with DCM between 1990 and 1999.
  • Analysis of routine therapies including digoxin, diuretics, ACE inhibitors, and heart transplantation.
  • Multivariate analysis to identify risk factors for adverse outcomes.

Main Results:

  • At last follow-up, 36% of patients recovered left ventricular systolic function, 30% had persistent cardiomyopathy, 22% underwent heart transplantation, and 12% died without transplantation.
  • Overall one-year survival was 90%, and five-year survival was 83%.
  • Younger age (<1 year), older age (>12 years), and female gender were associated with increased risk of death or transplantation; higher left ventricular shortening fraction was associated with decreased risk.

Conclusions:

  • Pediatric DCM patients exhibit diverse outcomes, with functional recovery being the most frequent positive result.
  • Heart transplantation has demonstrably improved survival rates in pediatric DCM patients.
  • Early identification of risk factors through echocardiography can inform management strategies.
Abstract

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