[Echocardiographic monitoring of the left ventricle in infants and children presenting the primary form of acute cardiac failure].

A retrospective multicenter study was based on influential echocardiograms performed in 34 children, the majority (29/34) being under 2 years of age, and presenting with a primary form of acute congestive heart failure. Four died early. The average duration of serial echocardiographic monitoring was 25 months (9-72 months) in the others. During the acute stage, the left cardiac cavities were extremely dilated and the shortening fraction was reduced to 15 +/- 4%. The 4 decreased children belonged to a group of 17 children who had a shortening fraction less than 13%. From the 8th day significant improvement of the left ventricular function was observed. Recovery was faster during the first 6 months of evolution and became very low after 1 year. The age at onset, the severity of the initial left ventricular changes, and the speed of recovery during the first 15 days were not predictive of the degree of eventual recovery of left ventricular function. At the end of the study 28 of the 30 surviving children had recovered a normal shortening fraction. However 16 of 30 still showed some dilatation, albeit moderate in most cases, of this ventricle. These data show that most children presenting with a primary form of acute congestive heart failure recover satisfactory heart function and that the initial echocardiographic features are not predictive of the subsequent course.