Pediatric Cardiology Division, Department of Paediatrics, Faculty of Medicine, Cairo University , Giza, Egypt.
Department of Pediatrics, Faculty of Medicine, Cairo University , Giza, Egypt.
Libyan J Med. 2020 Dec;15(1):1822073. doi: 10.1080/19932820.2020.1822073.
: Paediatric cardiomyopathies are rare but serious and often life-threatening conditions. In the absence of cardiac transplant and ventricular assist device as treatment options in our region, it is very important to identify patients at higher risk. The aim of this study was to determine the outcome of patients diagnosed with cardiomyopathies and their prognostic indicators. : This study included 92 cases representing all patients diagnosed with cardiomyopathy who were admitted into the pediatric cardiac intensive care unit during the period from January 2012 to September 2018. The patients were classified into two groups according to the outcome: the first group comprised 69 patients who survived, and the second group comprised 23 patients who died. All medical records were reviewed, and data were recorded and analysed. : Patients with cardiomyopathies represented 8.6% (92/1071) of all patients with cardiac diseases who were admitted in the study period and in the target age group (0.5-12 years). Dilated cardiomyopathy (DCM) was the most frequent type of cardiomyopathy among the admitted patients (80 patients), while 6 patients were diagnosed with hypertrophic cardiomyopathy (HCM), 4 were diagnosed with restrictive cardiomyopathy (RCM), and only 2 were diagnosed with mixed DCM-RCM. Seventy patients required inotropic support (76.1%). Assisted mechanical ventilation was used on 15 patients (16.3%). Twenty-three patients (25.0%) died during the 7-year study period. The occurrence of hypotension, abnormally high liver enzymes, the need for mechanical ventilation and the need for multiple inotropic drugs were found to be statistically significant predictors of mortality, while age, sex, fractional shortening, ejection fraction, presence of mitral regurgitation, mural thrombus, electrolyte disturbance and arrhythmias did not predict or affect patients' outcomes.
儿科心肌病罕见但严重,且常危及生命。在我们地区,心脏移植和心室辅助设备作为治疗选择尚未普及,因此识别高危患者非常重要。本研究旨在确定诊断为心肌病患者的结局及其预后指标。
本研究纳入了自 2012 年 1 月至 2018 年 9 月期间入住儿科心脏重症监护病房的所有诊断为心肌病的 92 例患者。根据结局将患者分为两组:第一组为 69 例存活患者,第二组为 23 例死亡患者。回顾所有病历,记录并分析数据。
心肌病患者占同期(0.5-12 岁)纳入研究的所有心脏病患者的 8.6%(92/1071)。扩张型心肌病(DCM)是住院患者中最常见的心肌病类型(80 例),6 例诊断为肥厚型心肌病(HCM),4 例诊断为限制型心肌病(RCM),仅有 2 例诊断为 DCM-RCM 混合型。70 例患者需要使用正性肌力药物(76.1%)。15 例患者(16.3%)接受辅助机械通气。在 7 年的研究期间,23 例患者(25.0%)死亡。低血压、肝酶异常升高、需要机械通气和需要多种正性肌力药物的发生被发现是死亡的统计学显著预测因子,而年龄、性别、短轴缩短率、射血分数、二尖瓣反流、壁血栓、电解质紊乱和心律失常均不能预测或影响患者结局。