Key result
Moderate or severe right ventricular systolic dysfunction in children with dilated cardiomyopathy was associated with death, mechanical support, or transplantation (OR 2.7; 95% CI 1.15-6.33; P=.023).
Why the study?
Does right ventricular systolic dysfunction assessed by TAPSE predict adverse outcomes in pediatric patients with dilated cardiomyopathy?
Cohort (n=96)
Does right ventricular systolic dysfunction assessed by TAPSE predict adverse outcomes in pediatric patients with dilated cardiomyopathy?
Answers are grounded in this paper and cite their sources.
In pediatric patients with dilated cardiomyopathy, moderate or severe right ventricular systolic dysfunction assessed by TAPSE is associated with a significantly higher risk of death, mechanical support, or transplantation.
BACKGROUND: Right ventricular systolic dysfunction (RVSD) is a predictor of outcomes in dilated cardiomyopathy (DCM) in adults, but little is known in children. Tricuspid annular plane systolic excursion (TAPSE) has emerged as a reliable tool to assess RVSD. We sought to determine the prevalence and prognostic significance of RVSD using TAPSE in children with DCM. METHODS: The first echocardiogram at the time of diagnosis with DCM was analyzed to obtain left ventricular ejection fraction (LVEF) and 2D TAPSE. RVSD was defined as TAPSE age-based z-score ≤-2. The association of a composite primary endpoint including death, mechanical support, or transplantation with RVSD was analyzed using LVEF and TAPSE. RESULTS: Of the 96 patients, RVSD was noted in 84 (88%). During a median follow-up of 17.5 months (IQR 1.4, 76.2), the primary endpoints were reached in 59%. There was a lower LVEF in patients with RVSD (P=.016). Moderate or severe RVSD showed a significant association with the composite primary endpoint (unadjusted OR 2.7 [95% CI: 1.15-6.33], P=.023). Kaplan-Meier analysis showed that the event-free survival was significantly lower in patients with LVEF ≤30% and TAPSE z-score ≤-4. CONCLUSION: Children with DCM have a high prevalence of RVSD based on reduced TAPSE, and those with moderate or severe RVSD have worse clinical outcomes.
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McLaughlin et al. (2016) conducted a cohort in Dilated cardiomyopathy (DCM) (n=96). Moderate or severe right ventricular systolic dysfunction (RVSD) assessed by TAPSE vs. No or mild RVSD was evaluated on Composite of death, mechanical support, or transplantation (OR 2.7, 95% CI 1.15-6.33, p=.023). Moderate or severe right ventricular systolic dysfunction in children with dilated cardiomyopathy was associated with death, mechanical support, or transplantation (OR 2.7; 95% CI 1.15-6.33; P=.023).
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