Incidence, causes and outcome of new-onset heart failure in children with no known heart disease in a French area

Abstract

Heart failure (HF) in children is a severe condition which diagnosis can be difficult [1] , [2] . We aimed at describing the incidence and outcome of new-onset HF with no know heart disease in the Loire-Atlantique area. We conducted a retrospective monocentric observational study between 2007 and 2016. We included all children under 16 years old with no known heart disease and new-onset HF confirmed by echocardiography. Data collected for the DIACARD study were used. One hundred and seventy-four children had a diagnosis of heart disease based on signs of HF during the study period. The incidence of new-onset HF in children was 1.92 per 100,000 including 0.91 per 100,000 due to cardiomyopathies and myocarditis (CM). 120 children had analyzable data including 60 with congenital heart diseases (CHD) and 57 with CM. Median age at diagnosis was 8 days (interquartile range 1–20.3 days) in CHD and 3 months (interquartile range 1–26 months) in CM. Among CHD, coarctation of the aorta was the most frequent diagnosis (21 children, 35%) followed by left-to-right shunts (12 children, 20%). Among CM, dilated cardiomyopathy (DCM) including myocarditis was the most frequent diagnosis (49 children, 86%). Overall one-year mortality rate was 17%, one-year neuro-motor sequel rate was 18%. More than half of the children with no known heart disease and new-onset HF are diagnosed with CHD. The incidence of CM in a French area is similar to the reported incidence in other industrialized countries [2] , [3] . Children diagnosed with HF signs have a high mortality rate.