Clinical profile of congestive cardiomyopathy in children

St. Louis University School of Medicine, Department of Pediatrics, Cardinal Glennon Children's Hospital, Missouri 63104.

The clinical profile of 23 children with congestive cardiomyopathy was reviewed to detect any factors that might be predictive for their survival. Factors examined include age at onset (less than 2 versus greater than 2 years), gender, severity of the clinical picture including data from the chest radiograph, electrocardiogram (ECG), echocardiogram, hemodynamic study and endomyocardial biopsy. Follow-up study ranged from 1 month to 14 years (mean 43 months). There were 12 survivors and 11 nonsurvivors; the 1 year mortality rate was 30% (7 of 23), and the 5 year mortality rate was 44% (10 of 23). Age at onset, gender, cardiothoracic ratio on chest radiograph, pattern of infarction, ST-T changes or arrhythmia on ECG and left ventricular end-diastolic pressure were nonpredictive of outcome. However, low shortening fraction (mean 11.5% in nonsurvivors versus 20.9% in survivors, p less than 0.01), familial cardiomyopathy and endocardial fibroelastosis indicated a very poor prognosis.

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