[Dilated cardiomyopathy in children and adolescents. Diagnostic problems, clinical course and prognosis].
The clinical profile of 19 patients with dilated cardiomyopathy from 2 to 18 years old (mean age 13.4 +/- 4 years) was reviewed to detect any factors that might be predictive for their survival. Follow-up study ranged from 5 to 105 months (mean 39 +/- 33 months). All patients received digitalis + diuretics, 12 were managed with immunosuppression, 16 with antiarrhythmics. There were 12 survivors and 7 nonsurvivors: the 1-year mortality was 21.2%, the 2-years mortality was 35.8%. All deaths were within first 2 years. In 12 patients who survived 2 years, significant improvement was noticed in 9 cases. Endomyocardial biopsy was performed in 16 patients. Four of them with histological diagnosis of myocarditis survived and in 3 of them a considerable improvement was noticed. Half of 12 patients with nonspecific histological findings died (p less than 0.05). There was no significant difference between survivors and nonsurvivors in all following parameters: the incidence of severe heart failure (NYHA class III-IV) and severe ventricular arrhythmias (Lown III-IV), relative heart volume, echocardiographic LVDD, haemodynamic parameters--CI, LVEF, LVEDP, LVEDVI.


CONCLUSIONS
Clinical, electrocardiographic, echocardiographic and haemodynamic data are nonpredictive for survival. The most dangerous period are the first two years of illness. In long term, improvement was noticed in half of patients.
Ciszewski
A
A
Kliniki Kardiologii Ogólnej Instytutu Kardiologii, Warszawie.
Bilińska
Z T
ZT
Lubiszewska
B
B
Popławska
W
W
Michalak
E
E
Walczak
F
F
Ruzyłło
W
W
D000293:Adolescent; D000638:Amiodarone / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004077:Digoxin / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D011379:Prognosis; D013997:Time Factors
D007166:Immunosuppressive Agents; D004077:Digoxin; D000638:Amiodarone
Kardiomiopatia rozstrzeniowa u dzieci i młodziezy. Problemy diagnostyczne, przebieg kliniczny i rokowania.