ABSTRACT
BACKGROUND: The aim of this study was to ascertain the clinical course and prognosis of dilated cardiomyopathy in Indian children. METHODS AND RESULTS: The records of 82 children with dilated cardiomyopathy (50 males), less than 12 years of age (mean age 2.9+/-3.07 years), were retrospectively reviewed. Clinical variables, laboratory parameters, and serial echocardiograms were analyzed. On a mean follow-up of 25.09 months (range 15 days-118 months), 9 out of 78 patients died (11.5%) (CI: 4.5%-18.5%). Mortality was 25% (6/24) in infants but the actuarial survival was 87% at 5 years in those diagnosed beyond infancy. Serial echocardiograms of 66 patients (80%) were available. Of these, 39 patients (59%) (CI: 47%-70%) improved, 12 (18%) (CI: 9%-27%) deteriorated or died, and 15 (23%) (CI: 13%-33%) remained unchanged during the follow-up. Among the prognostic variables, only age less than 1 year, higher cardiothoracic ratio, and a higher ratio of left ventricular diastolic dimension/posterior wall thickness was associated with a poor outcome on univariate analysis. CONCLUSIONS: Dilated cardiomyopathy in children pursues a heterogeneous course with a high mortality in infants. A large number of children diagnosed beyond infancy improve or recover. Further characterization of prognostic variables is warranted.