title: Natural history of dilated cardiomyopathy in children.
abstract: To assess the natural history and potential risk factors in childhood dilated cardiomyopathy, we investigated 25 patients (ages 9.6 +/- 4.4 years) who presented after they were 2 years old. All patients had symptoms of congestive heart failure and reduced contractility with a dilated left ventricle at presentation. Two factors at presentation were significantly different between patients who died less than 1 year after the presentation (n = 14) and those who survived for more than 1 year (n = 9); cardiothoracic ratio (65.1% +/- 6.8% vs 57.1% +/- 6.1%, p less than 0.01) and left ventricular ejection fraction (31.3% +/- 7.0% vs 40.0% +/- 6.2%, p less than 0.05). Irrespective of intensive medical therapy, dilated cardiomyopathy in children had a poor prognosis; the actuarial survival rate was 41% at 1 year and 20% at 3 years. Other forms of therapy should be considered in the early stages of dilated cardiomyopathy in this high-risk group.
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Akagi
authors.forename: L N
authors.initials: LN
authors.lastname: Benson
authors.forename: N E
authors.initials: NE
authors.lastname: Lightfoot
authors.forename: K
authors.initials: K
authors.lastname: Chin
authors.forename: G
authors.initials: G
authors.lastname: Wilson
authors.forename: R M
authors.initials: RM
authors.lastname: Freedom
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D002648:Child; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D015996:Survival Rate