Electrocardiographic and clinical characteristics of idiopathic restrictive cardiomyopathy in children.
BACKGROUND
Idiopathic restrictive cardiomyopathy (RCM) is not a single disease and is rare.


RESULTS
The clinical features and clinical course of 12 pediatric patients with RCM seen between 1978 and 2005 were retrospectively analyzed. The age at diagnosis ranged from 4 months to 12 years (median 4 years). The age of 7 patients diagnosed because of an abnormal electrocardiogram (ECG) ranged from 4 to 12 years. Three infants less than 2 years old presented with cardiomegaly. Obliquely elevated ST-T segments and the late peak T waves on 12-lead ECG were present in 8 patients (67%). Three patients with ST depression during exercise had no perfusion defects on radioisotope myocardial perfusion imaging. Two patients underwent orthotopic heart transplantation. Of the remaining 10 patients, 7 have died: 4 died suddenly and 3 died of right heart failure. Three patients with a hypertrophic left ventricular wall had a prolonged survival. The probability of survival at 1, 2 and 3 years was 78%, 52% and 26%, respectively.


CONCLUSIONS
Obliquely elevated ST-T segments and the late peak T wave on ECG are characteristic, and reflect the restrictive physiology, which may indicate abnormalities of repolarization of ventricular muscle. The mode of death was either heart failure from pulmonary hypertension or sudden death from presumed ventricular arrhythmia.
Hayashi
Tamaki
T
Department of Pediatrics, Nara Medical University, Kashihara, Japan. thayashi@naramed-u.ac.jp
Tsuda
Etsuko
E
Kurosaki
Kenichi
K
Ueda
Hatsue
H
Yamada
Osamu
O
Echigo
Shigeyuki
S
D000293:Adolescent; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002121:Calcium Channel Blockers / Q000494:pharmacology; D002313:Cardiomyopathy, Restrictive / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004232:Diuretics / Q000494:pharmacology; D004562:Electrocardiography; D005260:Female; D016027:Heart Transplantation / Q000502:physiology; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography; D008297:Male; D009206:Myocardium / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics