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Dilated cardiomyopathy in a pediatric population: etiology and outcome predictors - a single-center experience

Cristina Ciuca1, Luca Ragni1, Tammam Hasan1

  • 1Pediatric Cardiology & GUCH Unit, Cardiothoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, 40138, Italy.

Future Cardiology
|March 9, 2019
PubMed

Insights

Predictors of outcome in pediatric dilated cardiomyopathy (DCM) were identified. Younger age and less inotropic support predicted improved left ventricular function, while familial history predicted poorer outcomes in pediatric heart failure patients.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Heart Failure Management

Background:

  • Dilated cardiomyopathy (DCM) is a significant cause of heart failure in children.
  • Severe left ventricular dysfunction in pediatric DCM presents unique management challenges.
  • Understanding outcome predictors is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To identify predictors of clinical outcomes in pediatric patients hospitalized with DCM and severe left ventricular dysfunction.
  • To evaluate factors associated with survival free from heart transplantation.
  • To determine predictors of left ventricular function normalization.

Main Methods:

  • Retrospective analysis of 83 pediatric patients hospitalized for heart failure due to DCM.
  • Assessment of clinical data, including age, inotropic support, and DCM etiology.
  • Long-term follow-up to evaluate survival and cardiac function recovery.

Main Results:

  • Five-year survival free from heart transplantation was 69.8%.
  • Left ventricular function normalized in 39.8% of patients.
  • Younger age, less need for inotropic support, and non-idiopathic DCM predicted improved function.
  • Familial history of cardiac disease/sudden death and inotropic support during hospitalization were linked to poorer outcomes.

Conclusions:

  • Nearly 40% of pediatric DCM patients achieved complete cardiac function normalization.
  • Outcome variability in pediatric DCM is significantly influenced by the specific type of cardiomyopathy.
  • Identifying specific predictors can guide personalized management for pediatric heart failure.
Abstract

Keywords:
anthracycline-related cardiomyopathydilated cardiomyopathyheart failureheart transplantationidiopathic cardiomyopathyleft ventricular dysfunctionleft ventricular function normalizationleft ventricular noncompaction cardiomyopathymyocarditispediatric cardiomyopathy

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