Heart Stiffening in Pediatric Dilated Cardiomyopathy: Causes of Severity.

BACKGROUND

Cardiomyopathy, characterized by heart stiffness, can lead to heart failure. This study aimed to investigate aortic stiffness in children with dilated cardiomyopathy (DCM) to better understand its contribution to disease severity.

METHODS

This case-control study compared 48 children with DCM with 96 healthy children over a 10-year period starting in 2011. Aortic strain, aortic stiffness index, aortic distensibility, and pressure strain elastic modulus were measured. These parameters, along with several echocardiographic measures, were compared between the DCM and control groups. Statistical analyses were performed using SPSS 18, with a significance threshold set at a P value below 0.05.

RESULTS

The participants included 57.6% boys, with 58.3% in the DCM group and 57.35% in the control group (χ=0.014, P=0.905). The age range was 2 to 18 years, with mean ages of 11.08±4.63 years for the DCM group and 10.77±2.82 years for the control group (P=0.691). Significant differences between groups were observed in aortic distensibility (P=0.004), aortic stiffness β index (P=0.001), and pressure strain elastic modulus (P=0.004). Post-treatment analyses based on ejection fraction and fractional shortening cutoffs indicated no changes in elasticity parameters except for the aortic stiffness β index, which varied according to the Ross classification.

CONCLUSION

Children with DCM exhibited reduced aortic strain and aortic distensibility, as well as elevated aortic stiffness β index and pressure strain elastic modulus.