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Dilated cardiomyopathy in childhood: problems of diagnosis and long-term follow-up

A A Schmaltz, J Apitz, W Hort

    European Heart Journal
    |February 1, 1987
    PubMed

    Insights

    This study examines 13 children with dilated cardiomyopathy, finding varied outcomes and complications like rhythm disturbances. No clear predictors of survival were identified in this pediatric heart condition cohort.

    Area of Science:

    • Pediatric Cardiology
    • Cardiovascular Research
    • Pediatric Critical Care Medicine

    Background:

    • Dilated cardiomyopathy (DCM) in children presents a significant clinical challenge.
    • Understanding the clinical course and outcomes of pediatric DCM is crucial for management.
    • Existing literature often lacks detailed follow-up data on this specific demographic.

    Purpose of the Study:

    • To describe the clinical profile and long-term course of infants and children diagnosed with dilated cardiomyopathy.
    • To identify common complications and assess survival rates in this pediatric population.
    • To explore potential predictors of survival in pediatric DCM.

    Main Methods:

    • Retrospective analysis of 13 pediatric patients with dilated cardiomyopathy.
    • Exclusion of endocardial fibroelastosis and myocarditis via transvascular endomyocardial biopsy.
    • Assessment of cardiac function using echocardiographic parameters like fractional shortening and cardiac index.
    • Long-term follow-up to record clinical outcomes, complications, and survival.

    Main Results:

    • The study included 13 children (median age 2 years) with DCM.
    • Indicators of congestive heart failure included elevated cardio-thoracic ratio (0.67), depressed fractional shortening (13%), and low cardiac index (2.52 l/min/m²).
    • Over a mean follow-up of 41 months, 5 patients died, 4 stabilized, and 4 improved. Rhythm disturbances (23%) and thrombus formation (15%) were primary complications.

    Conclusions:

    • Dilated cardiomyopathy in children has a variable clinical course with significant morbidity and mortality.
    • Rhythm disturbances and thrombus formation are notable complications in pediatric DCM.
    • Predictors of survival remain elusive in this cohort, highlighting the need for further research.

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