Clinical features and prognostic factors in children with dilated cardiomyopathy

Abstract

Objective To discuss the clinical features and prognostic factors in the children with dilated cardiomyopathy(DCM). Methods The clinical data of 45 cases of DCM, including 27 boys and 18 girls, from May 2007 to Nov. 2011 in Wuhan Children's Hospital were analyzed by retrospective medical record survey methods. The average age of onset was(19.20±18.98) months. Eight cases (17.8%) were of cardiac function gradeⅠ-Ⅱ, and 37 cases (82.2%) were of cardiac function grade Ⅲ-Ⅳ. The patients whose left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) increased by 10%-15% compared with those before treatment were defined as improved group, and the patient's LVEF and LVFS levels declined persistently or those of dead cases were defined as worsened group. There were 34 cases assigned as the improved group, 8 cases as the worsened group, and 5 out of 8 cases were dead. The age, occurrence of abnormal Q waves, cardiac function, LVEF and LVFS in the 2 groups were analyzed. Results The cardiac troponin, creatine kinase, creatine kinase isoenzyme in the cardiac function grade Ⅲ-Ⅳ group were significantly higher than those in the cardiac function gradeⅠ-Ⅱ group (all P<0.01). There were 11 patients who had abnormal Q waves by electrocardiogram when they were diagnosed. The LVEF and LVFS levels in the cardiac function gradeⅠ-Ⅱ group were significantly higher than those in the cardiac function grade Ⅲ-Ⅳ group (all P<0.05). There were statistically significant differences in age on diagnosed, proportion of newly diagnosed cases age ≤1 year old, occurrence of abnormal Q waves, cardiac function in grade Ⅲ-Ⅳ, LVEF and LVFS levels between the improved group and the worsened group (all P<0.05). Conclusions Most of the children with DCM were diagnosed more when they were ≤ 1 year old, mostly with cardiac function grade Ⅲ-Ⅳ. The occurrence of abnormal Q waves, cardiac function grade, LVEF and LVFS levels could be used as important prognostic indicators for DCM. Key words: Dilated cardiomyopathy; Abnormal Q waves; Cardiac function; Left ventricular ejection fraction; Left ventricular shortening fraction