4 research outputs found
Practice variability in pediatric heart transplantation: Opportunities for collaboration
The pediatric heart transplant population continues to grow and more centers are now providing advanced heart failure and transplant services. Though more patients are surviving after transplant, pediatric center protocols have remained relatively unchanged with limited research to guide protocol optimization. The authors explore recent literature reviewing the impact of the different approaches to pre and post-transplant care and as well as the impact these variations have on the field and future directions
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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 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