Abstract 12481: Late Outcomes for Children With Non-Structural, Non-Arrhythmic Symptomatic Heart Failure: A Single Center’s 32-year Experience With 251 Patients
Background: Late outcomes for children presenting with heart failure due to myocardial muscle disease are currently unknown.
Methods: All children ≤18yrs admitted to our center with symptomatic heart failure 1/1/1980-31/12/2009 were identified and their charts reviewed. Patients with structural heart disease, arrhythmic etiology or ≤2 years follow-up were excluded. Data was censured at death or on 31/12/2011. Outcomes for patients no longer followed by us were obtained by contacting current healthcare providers.
Results: Of 257 children who met inclusion criteria 6 were lost to follow-up. The remaining 251(48% male) presented at a median (IQR) age of 1.7(0.29-7.83) years. Table 1 contains diagnostic details. Median duration of follow-up was 7.5 (3.0-12.8) years with 20 patients followed for >20 years. During their illness, 188 children (75%) required inotropes, 119(47%) ventilation, 23(9.1%) ECMO, 31(12.3%) VAD and 112(43%) underwent cardiac transplantation. Survival data are shown in Figure 1. In the 121 children who survived >2 years transplant-free there were 15 late deaths and 24 late transplants. In non-transplanted children late deaths occurred at a median of 4.8(2.2-10.0) years after initial presentation. There were 19 deaths in transplant recipients at a mean of 5.0(SD 4.3) years after transplant.
Conclusions: Although the greatest risk of mortality and transplantation occurs during the first year after presentation, children who present with symptomatic heart failure due to myocardial muscle disease face an ongoing late hazard, which exists whether they receive cardiac transplantation or not and suggests long term cardiology follow-up is required.
- © 2013 by American Heart Association, Inc.