Risk factors for long-term prognosis in children with dilated cardiomyopathy

Wen Haichu; Li Yang; Du Jie

doi:10.3760/j.issn.1673-4777.2024.09.003

Abstract：Objective To construct a long-term prognosis score in patients with pediatric dilated cardio-myopathy(PDCM)based on clinical risk factors and verify its risk stratification ability.Methods The clinical data of children with dilated cardiomyopathy(DCM)admitted to Beijing Anzhen Hospital,Capital Medical University from September 2015 to December 2019 were retrospectively analyzed.Children with DCM from September 2015 to March 2017 were enrolled as the discovery set(87 cases),and children with DCM from April 2017 to December 2019 were enrolled as the validation set(51 cases).According to the presence or absence of adverse events,the children with DCM were divided into event group and non-event group.Univariate Cox regression was used to screen clinical risk factors related to adverse events,and multivariate Cox regression coefficients was further used to assign weights to clinical risk factors to construct a prognostic score.Kaplan-Meier curves was used to assess the risk stratification ability of the scores.Results In the discovery set,the left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)in the event group were lower than those in the non-event group.The levels of blood urea nitrogen,serum uric acid and B-type natriuretic peptide(BNP)in the event group were higher than those in the non-event group(all P＜0.05).In the validation set,the age,serum creatinine and BNP in the event group were higher than those in the non-event group(all P＜0.05).Univariate Cox regression analysis showed that age,LVEF,LVFS,left ventricular end-diastolic diameter z score,BNP,blood urea nitrogen,serum uric acid and C-reactive protein were significantly correlated with adverse events(all P＜0.05).Multivariate Cox regression analysis finally included LVEF,BNP and C-reactive protein to construct the prognostic score.In validation set,after the use of prognostic score for layered,low-risk and high-risk children with DCM non-event survival rates were 81.2％and 51.1％respectively(Log-rank P=0.049).Conclusion The prognostic score of PDCM long-term adverse events based on clinical risk factors is construct,it can be used for risk stratification.