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Dilated cardiomyopathy in children and adults: what is new?

Galal E Nagib Elkilany1, Mustafa A Al-Qbandi, Khaled A Sayed

  • 1Adult Cardiology Department, Echocardiography Laboratory, Chest Hospital, Safat, Kuwait. galal_elkilany@yahoo.com

Thescientificworldjournal
|August 12, 2008
PubMed

Insights

Dilated cardiomyopathy (DCM) is a serious heart condition. Key risk factors for poor outcomes in children and adults include age, heart failure, and specific echocardiographic findings.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Imaging

Background:

  • Dilated cardiomyopathy (DCM) is the leading cause of heart transplantation in pediatric and young adult populations, with high associated mortality.
  • Limited established data exists regarding mortality, clinical course, and echocardiographic characteristics of DCM in children versus adults.
  • Understanding these factors is crucial for improving patient outcomes and management strategies.

Purpose of the Study:

  • To provide a comprehensive research article detailing the incidence, causes, outcomes, and risk factors of DCM.
  • To identify new echocardiographic criteria for assessing the risk of death in DCM patients.
  • To establish a clearer understanding of DCM's diverse clinical presentation and prognostic indicators.

Main Methods:

  • Retrospective analysis of pediatric and adult patient cohorts diagnosed with DCM.
  • Detailed echocardiographic assessments including ejection fraction, global strain, diastolic function, and valvular competence.
  • Statistical analysis to identify independent risk factors for mortality and need for cardiac transplantation or CRT.

Main Results:

  • In children, independent risk factors for death/transplantation included older age, heart failure, low ejection fraction (≤25%), low global strain, mitral incompetence, pulmonary hypertension, diastolic dysfunction, and right ventricular involvement.
  • In adults, risk factors included low ejection fraction (<30-35%), global peak systolic strain <-7.6%, increased end-diastolic volume (EDV), end-systolic volume (ESV), left bundle branch block (LBBB), diastolic dysfunction, and left ventricle dyssynchrony.
  • All identified risk factors were statistically significant (p<0.001).

Conclusions:

  • DCM is a heterogeneous disorder in both children and adults, with outcomes significantly influenced by the underlying cause, patient age, and heart failure status at presentation.
  • Echocardiographic parameters, including left ventricular systolic and diastolic function, pulmonary artery pressure, global strain, and mitral valve function, are critical determinants of prognosis.
  • This study offers novel insights into diagnostic criteria and risk stratification for DCM, paving the way for improved patient management.

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