Abstract 3793: Nutritional Status is Associated With Cardiac Outcomes and Mortality in Children With Idiopathic Dilated Cardiomyopathy
Objective: Impaired growth and nutrition can have an adverse impact on, or be a consequence of, chronic disease. The nutritional status of children with idiopathic dilated cardiomyopathy (IDCM) and the association of nutritional status on clinical endpoints, including mortality, have been poorly defined.
Methods: The Pediatric Cardiomyopathy Registry database was reviewed for children with complete entry data on weight (wt), height (ht), demographics, and echocardiography (echo). Ht and wt z-scores (z) and body mass index (BMI) were calculated. Mortality was determined at 1 y after entry into the registry. IDCM was dichotomized by diagnosis (dx) <1 y or ≥1 y of age. Proportional hazards regression was used to look at the comparative impact of ht, wt, and BMI on time-to-death. All regression models were adjusted for age and echo measures of disease severity. Comparisons were made between children dx <1 y and ≥1 year of age.
Results: Complete data were available for 759/1429 children with IDCM (53%); the 47% without complete data had similar demographic/echo outcomes. 317 (42%) had IDCM dx <1y (mean age=0.35 y) and 442 (58%) were dx ≥1y (mean age=8.8y). At entry, IDCM <1y had lower wt (−0.75 vs 0.05), ht (−0.47 vs −0.17) and wt/ht (−1.42 vs −0.17) z-scores than IDCM ≥1y. 1 y mortality rate was approximately 12% in each group. For IDCM <1y, univariate correlates to low ht z included male sex and no heart failure; for low BMI included high LV mass z. For IDCM ≥1y, univariate correlates to low ht z included high end-diastolic (EDD) and high end-systolic (ESD) dimension; for low BMI included female sex and higher age, LV mass, EDD and ESD. In a multivariate analysis, independent factors associated with 1 y mortality are shown in the Table⇓.
Conclusion: IDCM diagnosed <1y showed worse nutritional status than those diagnosed ≥1y. Cardiac dysfunction, especially in children dx ≥1y was correlated with low ht and BMI. Low ht z is an independent predictor of mortality in all children with IDCM.