Abstract 10895: The Association of Growth Patterns and Clinical Outcomes in Children With Dilated Cardiomyopathy: A Report From the Pediatric Cardiomyopathy Registry Study Group
Introduction: Although malnourishment is associated with mortality in adult dilated cardiomyopathy (DCM), a paradox exists where obesity is protective. We aim to look at the role of these risk factors in pediatric DCM.
Hypothesis: We hypothesize malnourishment (MN) and obesity are risk factors for death or heart transplantation.
Methods: The NHLBI- funded Pediatric Cardiomyopathy Registry (PCMR) database was used for this analysis of patients (age < 18 years) with idiopathic or familial DCM and myocarditis. Patients were categorized by anthropological measurements: MN (defined as BMI <5% for ≥2years or weight for length <5% for <2 years), obese (BMI> 95% for ages ≥2years or weight for length >95% for <2 years), and normal.
Results: Of 904 DCM patients, 23.7% (214) were MN, 13.3% (120) were obese, and 63.1% (570) were normal (Table). Obese patients were significantly older (p<0.001) and more likely to have a family history of DCM (both p<0.05). MN were more likely to have congestive heart failure, increased cardiac dimensions, and higher ventricular mass (p<0.01). In a Kaplan Meier analysis, there was a difference in time to death or transplant by groups (Figure, p=0.0498). Adjusting for age and myocarditis, MN was associated with increased risk of death (HR: 1.857, 95%CI: 1.159-2.977, p=<0.001), but obesity was not (HR: 1.362, 95%CI: 0.722, 2.566). Competing outcome analysis showed an increased risk of death for MN (p=0.026) but no difference between groups in transplant rate (p=0.159).
Conclusion: Malnourishment is significantly associated with poor clinical outcomes. Unlike adult DCM where obesity is protective, obesity is not associated with improved survival in pediatric DCM.
Author Disclosures: C. Castleberry: None. J.L. Jefferies: None. L. Shi: None. J.D. Wilkinson: None. J.A. Towbin: None. R.W. Harrison: None. C. Canter: None. J. Rossano: None. E. Pahl: None. T. Lee: None. L. Addonizio: None. P. Rusconi: None. J. Godown: None. J. Mahgerefteh: None. S.D. Colan: None. P.F. Kantor: None. S.E. Lipshultz: None. T. Miller: None.
- © 2015 by American Heart Association, Inc.