Dilated cardiomyopathy in children: clinical course and prognosis.
The clinical profile of 19 patients with dilated cardiomyopathy ages 2-18 years (mean 13.4 +/- 4 years) was reviewed to detect any factors that might be predictive for their survival. Follow-up range from 5 to 105 months (mean 39 +/- 33 months). Routine treatment consisted of digitalis and diuretics: 14 patients received antiarrhythmics, 6 received vasodilators, and 12 were managed with immunosuppression. There were 12 survivors and 7 nonsurvivors: The 1-year mortality was 21.2% and the 2-year mortality 35.8%. All deaths were within first 2 years. Of the 12 patients who survived 2 years, a significant improvement was noticed in 9. In 3 patients tachycardia-induced cardiomyopathy was diagnosed, and abolition of supraventricular tachycardia was followed by improvement and regression of cardiomegaly. Endomyocardial biopsy was performed in 16 patients. Four with a histologic diagnosis of active myocarditis survived, and in 3 of them a considerable improvement was noticed. Of the 12 patients with nonspecific histologic findings, 6 died (p < 0.05). There were no significant differences between survivors and nonsurvivors for any of the following parameters: incidence of severe heart failure (NYHA class III-IV) and severe ventricular arrhythmias (Lown class III-V), relative heart volume, echocardiographic left ventricular diastolic diameter and shortening fraction, and the hemodynamic parameters of cardiac index, left ventricular ejection fraction, left ventricular end-diastolic pressure, and left ventricular end-diastolic volume index.
Ciszewski
A
A
Institute of Cardiology, School of Medicine, Warsaw, Poland.
Bilinska
Z T
ZT
Lubiszewska
B
B
Ksiezycka
E
E
Poplawska
W
W
Michalak
E
E
Walczak
E
E
Walczak
F
F
Ruzyllo
W
W
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology*; D002648:Child; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009206:Myocardium / Q000473:pathology; D011379:Prognosis
D000889:Anti-Arrhythmia Agents; D007166:Immunosuppressive Agents