Serum Parameters and Echocardiographic Predictors of Death or Need for Transplant in Newborns, Children, and Young Adults With Heart Failure

Patel, Mit; Berg, Alexandria M.; Vincent, Robert; Mahle, William T.

doi:10.1016/j.amjcard.2010.01.357

Cited by 19 publications

(13 citation statements)

References 15 publications

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“…Patel and colleagues recently developed a model that incorporates percent lymphocytes, serum creatinine, and serum sodium to predict death or the need for transplant for pediatric patients hospitalized for heart failure; however, they did not extrapolate their data to include rehospitalization or 1-year outcomes. 6 Furthermore, their study included a heterogeneous population of patients with cardiomyopathies as well as congenital heart disease. As it is not known whether these groups behave similarly, interpretation of this model is challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Adult studies, including the Seattle Heart Failure Study, have attempted to use this data to predict death or urgent transplantation in patients with heart failure, and studies in pediatric populations have attempted to validate this model in children. 5,6 In 2010, Patel et al reported that percent lymphocytes, sodium, and creatinine were predictive of death or transplant for children hospitalized with heart failure. In their study of 99 patients, however, only 58 children had DCM, while the remainder (41; 41%) had heart failure of varied etiology, including congenital heart disease.…”

Section: Clinical Perspective On P 443mentioning

confidence: 99%

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Outcomes of Children Following a First Hospitalization for Dilated Cardiomyopathy

Hollander

Bernstein

Yeh

et al. 2012

Circ: Heart Failure

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Background-We hypothesized that children with dilated cardiomyopathy who require hospital admission are at increased risk for death or transplantation during their first hospitalization and in the first year that follows. We also assessed the value of routine data collected during that time to predict death or the need for transplantation prior to discharge and within 1 year of admission. Methods and Results-We conducted a retrospective review of 83 pediatric patients with dilated cardiomyopathy whose initial hospitalization fell between 2004 and 2009. The mean age at hospitalization was 7 years. The majority of patients demonstrated moderate or severe left ventricular dysfunction on initial echocardiogram (80%) and/or the need for intravenous inotropes within 7 days of hospital admission (69%). Five patients (6%) died, and 15 (18%) were transplanted in the initial hospitalization. At 1 year, 11/71 (15%) had died, and 27/71 (38%) were transplanted. The overall freedom from death, transplantation, or rehospitalization at 1 year following admission was 21%. Fractional shortening, left ventricular ejection fraction, serum cholesterol, uric acid, mixed venous saturation , and atrial filling pressures were all predictive of death or transplantation during the initial hospitalization. Left ventricular ejection fraction was predictive of death or transplantation at 1 year. Conclusions-The first hospitalization for dilated cardiomyopathy marks a period of high risk for clinical decline, end stage heart failure, and the need for cardiac transplantation. Echocardiographic function and hemodynamic and serum measurements may aid in predicting outcomes. Despite medical management, most patients will be rehospitalized and/or require cardiac transplantation within 1 year of admission. freedom from death or transplantation during the index hospitalization and at 1 year of follow-up. To our knowledge, this contemporary and homogenous cohort is the largest singleinstitution experience reported for hospitalized pediatric patients with DCM published to date. Methods Study Cohort and Data SourceWe identified and performed a retrospective chart review on 83 patients with DCM who had at least 1 hospitalization at Lucile Packard Children's Hospital at the time of, or subsequent to, their diagnosis between January 1, 2004, and December 31, 2009, of which 71 had reached the end point of death, transplantation, or had at least 1 year of follow-up. The diagnosis of DCM was based on the echocardiographic appearance of left ventricular dilatation and reduced left ventricular ejection fraction (LVEF), consistent with the approach taken in large pediatric registries. 3,7,8 Secondary diagnoses included DCM identified as primary idiopathic/familial or secondary to myocarditis, anthracycline toxicity, arrhythmias leading to heart failure, or genetic, neuromuscular, metabolic, or autoimmune disease. DCM was defined as idiopathic if no specific etiology of DCM was discovered and there were no affected family members. Myocarditis was either biopsy-p...

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Perspective On P 443mentioning

confidence: 99%

Outcomes of Children Following a First Hospitalization for Dilated Cardiomyopathy

Hollander

Bernstein

Yeh

et al. 2012

Circ: Heart Failure

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“…However, the independent association of the HN to the PRA and diuretic use implies that the main cause of HN in our pediatric patients is the negative balance of Na by the diuretic use, resulting in hypovolemic‐related activation of the RAAS. Although HN is associated with a high mortality even in pediatric patients in many critical settings, 20 the chronic situation in our pediatric patients may not be the same case as those critical settings. A smaller body size is one of the risk factors for HN under the conditions of exercise and diuretic medication in adults 21,22 .…”

Section: Discussionmentioning

confidence: 87%

Hyponatremia and Its Association with the Neurohormonal Activity and Adverse Clinical Events in Children and Young Adult Patients after the Fontan Operation

Ohuchi

Negishi

et al. 2011

Congenital Heart Disease

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“…Several studies have examined cell line abnormalities as predictors of morbidity and mortality in children and adults with cardiac disease or those undergoing cardiac surgery 2‐10 . Among the most commonly studied abnormalities were thrombocytopenia, lymphopenia, and neutrophilia.…”

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confidence: 99%

“…On the other hand, lymphopenia has been commonly demonstrated in children and adults with chronic heart disease, presumably as a result to increased cortisol and catecholamine levels from the prolonged stress response associated with these long‐lasting cardiac illnesses. Accordingly, several groups have used lymphopenia as a marker for the need of heart transplantation or survival in children and adults with heart failure 5‐7 . Consequently, it is plausible that lymphopenia is merely a surrogate to increased preoperative stressed state, making those patients more likely to progress slowly (or have worse outcomes in some studies) following cardiac surgery.…”

mentioning

confidence: 99%

Preoperative cell line abnormalities in children with chronic cardiac disease: Symbol or surrogate?

Alsoufi

2020

J Card Surg

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Serum Parameters and Echocardiographic Predictors of Death or Need for Transplant in Newborns, Children, and Young Adults With Heart Failure

Cited by 19 publications

References 15 publications

Outcomes of Children Following a First Hospitalization for Dilated Cardiomyopathy

Outcomes of Children Following a First Hospitalization for Dilated Cardiomyopathy

Hyponatremia and Its Association with the Neurohormonal Activity and Adverse Clinical Events in Children and Young Adult Patients after the Fontan Operation

Preoperative cell line abnormalities in children with chronic cardiac disease: Symbol or surrogate?

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