Dilated cardiomyopathy in Indian children.
BACKGROUND
The aim of this study was to ascertain the clinical course and prognosis of dilated cardiomyopathy in Indian children.


RESULTS
The records of 82 children with dilated cardiomyopathy (50 males), less than 12 years of age (mean age 2.9+/-3.07 years), were retrospectively reviewed. Clinical variables, laboratory parameters, and serial echocardiograms were analyzed. On a mean follow-up of 25.09 months (range 15 days-118 months), 9 out of 78 patients died (11.5%) (CI: 4.5%-18.5%). Mortality was 25% (6/24) in infants but the actuarial survival was 87% at 5 years in those diagnosed beyond infancy. Serial echocardiograms of 66 patients (80%) were available. Of these, 39 patients (59%) (CI: 47%-70%) improved, 12 (18%) (CI: 9%-27%) deteriorated or died, and 15 (23%) (CI: 13%-33%) remained unchanged during the follow-up. Among the prognostic variables, only age less than 1 year, higher cardiothoracic ratio, and a higher ratio of left ventricular diastolic dimension/posterior wall thickness was associated with a poor outcome on univariate analysis.


CONCLUSIONS
Dilated cardiomyopathy in children pursues a heterogeneous course with a high mortality in infants. A large number of children diagnosed beyond infancy improve or recover. Further characterization of prognostic variables is warranted.
Kothari
Shyam S
SS
Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi. kothariss@vsnl.com
Dhopeshwarkar
Rajesh A
RA
Saxena
Anita
A
Juneja
Rajnish
R
D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis