Natural history of dilated cardiomyopathy in children

To assess the natural history and potential risk factors in childhood dilated cardlomyopathy, we investigated 25 patients (ages 9.6 ± 4.4 years) who presented after they were 2 years old. All patients had symptoms of congestive heart failure and reduced contractility with a dilated left ventricle at presentation. Two factors at presentation were significantly different between patients who died less than 1 year after the presentation (n = 14) and those who survived for more than 1 year (n = 9); cardiothoracic ratio (65.1% ± 6.8% vs 57.1% ± 6.1%, p < 0.01) and left ventricular ejection fraction (31.3% ± 7.0% vs 40.0% ± 6.2%, p < 0.05). Irrespective of intensive medical therapy, dilated cardiomyopathy in children had a poor prognosis; the actuarial survival rate was 41% at 1 year and 20% at 3 years. Other forms of therapy should be considered in the early stages of dilated cardiomyopathy in this high-risk group.