| Objective: To observe the frequency and explore the predictors of left ventricular reverse remodeling(LVRR)in children with recent onset dilated cardiomyopathy on tailored medical therapy.Methods: Children hospitalized with recent onset dilated cardiomyopathy and endocardial fibroelastosis in Children's hospital of Chongqing Medical University from February 2012 to November 2018 were reviewed and followed up to January 2020 or death.Children were treated with tailored medical therapy.LVRR was defined as an at least 10% increase in left ventricular ejection fraction(LVEF)and to a final level of ?55%,and an at least 10% decrease in left ventricular end-diastolic dimension z score(LVEDD-Z)and to a final level of ?2 on repeat echocardiogram.Clinical and echocardiographic variables at baseline were evaluated to identify predictors of LVRR by multivariable logistic regression analysis.Results: A total of 55 children were enrolled in this analysis.During a median follow-up period of 33 months(range 1 to 85 months)with repeat echocardiography,25 children(45.5%)were defined as LVRR,LVEF increased from(37.1±7.4)% at baseline to(65.7±5.4)% on follow-up(P<0.001),and LVEDD-Z decreased from 9.5±3.0 at baseline to 1.3±0.6 on follow-up(P < 0.001)in these children.Univariable logistic regression analysis showed that pulmonary arterial hypertension,moderate to severe tricuspid regurgitation,and serum albumin levels at baseline were associated with LVRR.Multivariable logistic regression analysis showed that moderate to severe tricuspid regurgitation(no moderate to severe tricuspid regurgitation vs.moderate to severe tricuspid regurgitation,OR=9.482,P<0.05)were independent predictor of LVRR.Conclusions: On current tailored medical therapy,LVRR could be achieved in about half of children with RODCM.Children with no moderate to severe TR at baseline are associated with a higher likelihood of occurrence of LVRR. |
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