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Functional Class in Children with Idiopathic Dilated Cardiomyopathy. A pilot Study
Aline Cristina Tavares1, Edimar Alcides Bocchi1, Guilherme Veiga Guimarães1
1Instituto do Coração, Hospital Sírio-libanês, São Paulo, SP, Brazil.
Insights
Children with idiopathic dilated cardiomyopathy (IDCM) can use drawings for self-classification of functional capacity. This self-classification correlates with medical assessments and Weber's stratification, aiding in understanding their condition.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Clinical Assessment
Background:
- Idiopathic dilated cardiomyopathy (IDCM) is a leading cause of death in children.
- Low left ventricular ejection fraction (LVEF) and functional capacity (FC) are key mortality indicators.
- Children cannot reliably self-report their functional capacity.
Purpose of the Study:
- To determine if children's, parents', and medical staff's functional capacity classifications align.
- To investigate the correlation between VO2 max and Weber's classification in pediatric IDCM patients.
Main Methods:
- Prepubertal children diagnosed with IDCM and heart failure (HF) were evaluated.
- Cardiopulmonary exercise testing (CPET) and functional class assessments were performed.
- Statistical analyses, including Chi-square tests, were used to compare classifications.
Main Results:
- A significant association was found between medical staff (CFm) and parent (CFp) functional classifications (p=0.002).
- No significant associations were observed between parent (CFp) and child (CFc) classifications, or between medical staff (CFm) and child (CFc) classifications.
- Weber's classification showed significant correlations with medical staff (CFm), parent (CFp), and child (CFc) classifications (p<0.05).
Conclusions:
- Utilizing drawings facilitated children's self-classification of functional capacity (NYHA).
- Children's self-classification, aided by drawings, correlated with Weber's stratification.
- This approach may improve the understanding of functional status in pediatric IDCM.
Background:
Idiopathic dilated cardiomyopathy (IDCM), most common cardiac cause of pediatric deaths, mortality descriptor: a low left ventricular ejection fraction (LVEF) and low functional capacity (FC). FC is never self reported by children.
Objective:
The aims of this study were (i) To evaluate whether functional classifications according to the children, parents and medical staff were associated. (iv) To evaluate whether there was correlation between VO2 max and Weber's classification.
Method:
Prepubertal children with IDCM and HF (by previous IDCM and preserved LVEF) were selected, evaluated and compared. All children were assessed by testing, CPET and functional class classification.
Results:
Chi-square test showed association between a CFm and CFp (1, n = 31) = 20.6; p = 0.002. There was no significant association between CFp and CFc (1, n = 31) = 6.7; p = 0.4. CFm and CFc were not associated as well (1, n = 31) = 1.7; p = 0.8. Weber's classification was associated to CFm (1, n = 19) = 11.8; p = 0.003, to CFp (1, n = 19) = 20.4; p = 0.0001and CFc (1, n = 19) = 6.4; p = 0.04).
Conclusion:
Drawing were helpful for children's self NYHA classification, which were associated to Weber's stratification.
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