Ranya A. Hegazy
Department of Pediatrics,
Faculty of Medicine,
Cairo University, Egypt
Rasha I. Ammar
Department of Pediatrics,
Faculty of Medicine,
Cairo University, Egypt
Mona F. Ezz El Deen Saleh
Department of Pediatrics, Research Institute of Ophthalmology, Egypt
ABSTRACT
The present research aimed at defining simple prognostic indicators for children suffering DCM. A retrospective analytic study was conducted that included 284 pediatric patients diagnosed with DCM and 112 age and sex matched children as controls. All included subjects underwent; twelve lead-ECG; Holter recording and transthoracic Doppler echocardiographic examinations were carried out in all patients. Statistical Package for Social Science (SPSS) version 9.0 was used for analysis of data. Poor outcome indicators identified by logistic regression analysis included longer disease duration, higher P-wave dispersion, bigger LVEDD, lower fractional shortening and presence of mitral regurge. Risk factors identified from 24 h ECG monitoring were higher maximum and minimum were higher maximum and mean heart rates and presence of nonsustained ventricular tachycardia. Cox regression analysis, identified bigger LVEDD, lower FS% and presence of non sustained VT as predictors of bad outcome. We conclude that LVEDD, FS%, MR, non sustained ventricular tachycardia and higher maximum and average heart rates on ambulatory ECG monitoring are prognostic indicators for outcome in children with DCM. P-wave dispersion is higher among patients with poor outcome and may carry prognostic significance that will need further evaluation. QT dispersion has no prognostic significance in children with DCM.
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How to cite this article
Ranya A. Hegazy, Rasha I. Ammar and Mona F. Ezz El Deen Saleh, 2008. Non-Invasive Indicators for Outcome in Children with Dilated Cardiomyopathy. Journal of Medical Sciences, 8: 118-124.
DOI: 10.3923/jms.2008.118.124
URL: https://scialert.net/abstract/?doi=jms.2008.118.124
DOI: 10.3923/jms.2008.118.124
URL: https://scialert.net/abstract/?doi=jms.2008.118.124
REFERENCES
- Alonso, J., P. Martinez, V.I. Cygankiewicz, M. Pitzalis and A. Baye et al., 2005. Dynamics of ventricular repolarization in patients with dilated cardiomopathy versus healthy subjects. Ann. Nonivasive Electrocardiol., 10: 121-128.
Direct Link - Amiya, E., K. Tanabe, Y. Ikari, Y. Nakajima and K. Hara, 2006. Prolonged QRS duration and severity of mitral regurgitation are unfavorable prognostic markers of heart failure in patients with nonischemic dilated cardiomyopathy. Circ. J., 70: 57-62.
Direct Link - Azevedo, V., F. Filho, M. Santos, M. Castier and B. Tura, 2004. How can the echocardiogram be useful for predicting death in children with idiopathic dilated cardiomyopathy? Arq. Bras. Cardiol., 82: 510-514.
Direct Link - Baker, R.L. and T.M. Koelling, 2005. Prognostic value of ambulatory electrocardiography monitoring in patients with dilated cardiomyopathy. J. Electrocardiol., 38: 64-68.
Direct Link - Barbieri, A., F. Grigioni, F. Bursi, L. Reggianini and S. Bonatti et al., 2006. Role of severe functional mitral regurgitation in predicting electrical remodeling in idiopathic dilated cardiomyopathy. J. Cardiovasc. Med., 7: 691-695.
Direct Link - Berger, R.D., E.K. Kasper, K.L. Baughman, E. Marban, H. Calkins and G.F. Tomaselli, 1997. Beat-to-beat QT interval variability: Novel evidence for repolarization lability in ischemic and nonischemic dilated cardiomyopathy. Circulation, 296: 1557-1565.
PubMed - Bostan, O.M. and E. Cil, 2006. Dilated cardiomyopathy in childhood: Prognostic features and outcome. Acta Cardiol., 61: 169-174.
Direct Link - Davey, P.P., J. Bateman, I.P. Mulligan, C. Forfar, C. Barlow and G. Hart, 1994. QT interval dispersion in chronic heart failure and left ventricular hypertrophy: Relation to autonomic nervous system and Holter tape abnormalities. Br. Heart J., 71: 268-273.
CrossRefDirect Link - Day, C.P., J.M. McComb and R.W. Cambell, 1990. QT dispersion: An indication of arrhythmic risk in patients with long QT intervals. Br. Heart J., 63: 342-344.
CrossRef - Dilaveris, P.E., E.J. Gialafos, S.K. Sideris, A.M. Theopistou and G.K. Andrikopoulos et al 1998. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am. Heart J., 135: 733-738.
PubMed - Dilaveris, P., E. Gialafos, G. Andikopoulos, D. Richter, V. Papanikolaou, K. Poralis and J.E. Gialafos, 2000. Clinical and electrocardiographic predictors of recurrent atrial fibrillation. Pacing Clin. Electrophysiol., 23: 352-358.
Direct Link - Fauchier, L., J. Douglas, D. Babuty, P. Cosnay and J.P. Fauchier, 2005. QT dispersion in nonischemic dilated cardiomyopathy. A long-term evaluation. Eur. J. Heart Fail, 27: 277-282.
Direct Link - Fei, L., J.H. Goldman, K. Prasad, P.J. Keeling and K. Reardon et al., 1996. QT dispersion and RR variations on 12-lead ECGs in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy. Eur. Heart J., 17: 258-263.
PubMed - Galinier, M., J.C. Vialette, J. Fourcade, P. Cabrol and B. Dongay et al., 1998. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur. Heart J., 19: 1054-1062.
PubMed - Grimm, W., M. Christ, J. Bach, H. Muller and B. Maisch, 2003. Non invasive arrhythmia risk stratification in idiopathic dilated cardiomyopathy. Circulation, 108: 2883-2891.
Direct Link - Huh, J., C.I. Noh and Y.S. Yun, 2004. The usefulness of surface electrocardiogram as a prognostic predictor in children with idiopathic dilated cardiomyopathy. J. Korean Med. Sci., 19: 652-655.
Direct Link - Leenhardt, A., F. Extramiana, P. Milliez, P. Maison-Blanche and I. Denjoy et al., 2001. New markers for the risk of sudden death: Analysis of ventricular repolarization. Arch. Mal. Coeur. Vaiss, 94: 23-30.
Direct Link - Martin, A.B., A. Jr. Garson and J.C. Perry, 1994. Prolonged QT interval in hypertrophic and dilated cardiomyopathy in children. Am. Heart J., 127: 64-70.
CrossRef - Morgera, T., A. Di Lenarda, G. Sabbadini, S. Rakar, E. Carniel, M. Driussi and G. Sinagra, 2004. Idiopathic dilated cardiomyopathy: Prognostic significance of electrocardiographic and electrophysiologic findings in the nineties. Ital. Heart J., 5: 593-603.
Direct Link - Nogueira, G., F.F. Pinto, A. Paixao and S. Kaku, 2000. Idiopathic dilated cardiomyopathy in children: Clinical profile and prognostic determinants. Rev. Port Cardiol., 19: 191-200.
Direct Link - Ozdemir, O., M. Soylu, A.D. Demir, S. Topaloglu and O. Alyan et al., 2004. P-wave durations as a predictor for atrial fibrillation development in patients with hypertrophic cardiomyopathy. Int. J. Cardiol., 94: 163-166.
Direct Link - Sahn, D.J., A. DeMaria, J. Kisslo and A. Weyman, 1978. Recommendations regarding quantitation in M-Mode echocardiography: Results of a survey of echocardiographic measurements. Circulation, 58: 1072-1083.
Direct Link - Senen, K., H.T. Riza, A. Erbay, N. Basar and I. Saatc et al., 2004. P-wave duration and P-wave dispersion in patients with dilated cardiomyopathy. Eur. J. Heart Fail., 6: 567-569.
Direct Link - Statters, D.J., M. Malik, D.E. Ward and A.J. Camm, 1994. QT dispersion: Problems of methodology and clinical significance. J. Cardiovasc. Electrophysiol., 5: 672-685.
CrossRef - Surawicz, B., 1996. Will QT dispersion play a role in clinical decision-making? J. Cardiovasc. Electrophysiol., 7: 777-784.
PubMed - Tajik, A.J., J.B. Seward and D.J. Hagler, 1978. Two-dimensional real-time ultrasonic imaging of the heart and great vessels-technique, image orientation, structure identification and validation. Mayo. Clin. Proc., 53: 271-303.
PubMed - Zecchin, M., A. Di Lenarda, D. Gregori, M. Moretti and M. Driussi et al., 2005. Prognostic role of non-sustained ventricular tachycardia in a large cohort of patients with idiopathic dilated cardiomyopathy. Ital. Heart J., 6: 721-727.
Direct Link