Chen Cheng, Huang Yanyun, Su Danyan, Qin Suyuan, Ye Bingbing, Huang Yuqin, Liu Dongli, Pang Yusheng
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Difficult and Critical Iillness Center, Pediatric Clinical Medical Research Center of Guangxi, Nanning 530021, China.
Children (Basel). 2024 Aug 15;11(8):992. doi: 10.3390/children11080992.
The reported outcomes of pediatric dilated cardiomyopathy (DCM) have varied across studies. There are few outcome data concerning DCM in Chinese children. Therefore, we conducted a retrospective study to describe clinical features and determine risk factors for poor outcomes in children with DCM.
We enrolled 121 children with DCM in our hospital from 2003 to 2021. General information and laboratory and echocardiographic data were collected and analyzed. Cox regression analysis was performed to determine risk factors for poor outcomes.
This study included 121 patients (69 males and 52 females). The median age at diagnosis was 10.8 years, and the follow-up time was 10.0 months. Eighty-two patients (67.8%) exhibited cardiac function classes III-IV at the time of diagnosis. Tachypnea was the most common symptom (78.5%). In echocardiography, the mean left ventricular end-diastolic dimension z score was 7.36 ± 2.73, and the left ventricular ejection fraction z score was -6.58 ± 2.17. The 1-, 2-, and 5-year survival rates were 51.2%, 43.8%, and 32.2%, respectively. Cox analysis revealed that cardiac function classes III-IV (hazard ratio [HR] = 1.801, 95% confidence interval [95% CI] = 1.030-3.149, = 0.039) and calcium levels (HR = 0.219, 95% CI = 0.084-0.576, = 0.002) were predictors of poor outcomes in children with DCM.
Children with DCM are at high risk of death. Cardiac function class III-IV and calcium levels were related to the prognosis of pediatric DCM patients.
不同研究报道的小儿扩张型心肌病（DCM）的预后有所不同。关于中国儿童DCM的预后数据较少。因此，我们进行了一项回顾性研究，以描述其临床特征并确定小儿DCM预后不良的危险因素。
我们纳入了2003年至2021年在我院就诊的121例小儿DCM患者。收集并分析了患者的一般信息、实验室检查及超声心动图数据。采用Cox回归分析确定预后不良的危险因素。
本研究共纳入121例患者（男69例，女52例）。诊断时的中位年龄为10.8岁，随访时间为10.0个月。82例患者（67.8%）在诊断时心功能分级为III-IV级。呼吸急促是最常见的症状（78.5%）。超声心动图检查显示，左心室舒张末期内径z值平均为7.36±2.73，左心室射血分数z值为-6.58±2.17。1年、2年和5年生存率分别为51.2%、43.8%和32.2%。Cox分析显示，心功能III-IV级（风险比[HR]=1.801，95%置信区间[95%CI]=1.030-3.149，P=0.039）和血钙水平（HR=0.219，95%CI=0.084-0.576，P=0.002）是小儿DCM患者预后不良的预测因素。
小儿DCM患者死亡风险高。心功能III-IV级和血钙水平与小儿DCM患者的预后相关。
