Circulation. 2019 Jul 2;140(1):e9-e68. doi: 10.1161/CIR.0000000000000682. Epub 2019 May 28.
In this scientific statement from the American Heart Association, experts in the field of cardiomyopathy (heart muscle disease) in children address 2 issues: the most current understanding of the causes of cardiomyopathy in children and the optimal approaches to diagnosis cardiomyopathy in children. Cardiomyopathies result in some of the worst pediatric cardiology outcomes; nearly 40% of children who present with symptomatic cardiomyopathy undergo a heart transplantation or die within the first 2 years after diagnosis. The percentage of children with cardiomyopathy who underwent a heart transplantation has not declined over the past 10 years, and cardiomyopathy remains the leading cause of transplantation for children >1 year of age. Studies from the National Heart, Lung, and Blood Institute-funded Pediatric Cardiomyopathy Registry have shown that causes are established in very few children with cardiomyopathy, yet genetic causes are likely to be present in most. The incidence of pediatric cardiomyopathy is ≈1 per 100 000 children. This is comparable to the incidence of such childhood cancers as lymphoma, Wilms tumor, and neuroblastoma. However, the published research and scientific conferences focused on pediatric cardiomyopathy are sparcer than for those cancers. The aim of the statement is to focus on the diagnosis and classification of cardiomyopathy. We anticipate that this report will help shape the future research priorities in this set of diseases to achieve earlier diagnosis, improved clinical outcomes, and better quality of life for these children and their families.
在这份来自美国心脏协会的科学声明中,儿童心肌病(心肌疾病)领域的专家解决了两个问题:儿童心肌病病因的最新认识和儿童心肌病的最佳诊断方法。心肌病导致一些最严重的儿科心脏病学结果;近 40%出现症状性心肌病的儿童在诊断后 2 年内接受心脏移植或死亡。过去 10 年来,接受心脏移植的心肌病儿童比例没有下降,心肌病仍然是 1 岁以上儿童移植的主要原因。美国国立心肺血液研究所资助的儿科心肌病注册研究表明,极少数心肌病儿童的病因已确定,但大多数可能存在遗传原因。儿科心肌病的发病率约为每 10 万名儿童中有 1 名。这与淋巴瘤、肾母细胞瘤和神经母细胞瘤等儿童癌症的发病率相当。然而,针对儿科心肌病的已发表研究和科学会议比针对这些癌症的研究和科学会议要少。本声明的目的是关注心肌病的诊断和分类。我们预计,该报告将有助于确定这组疾病的未来研究重点,以实现更早的诊断、改善临床结果和提高这些儿童及其家庭的生活质量。