Management of children with dilated cardiomyopathy in The Netherlands
| العنوان: | Management of children with dilated cardiomyopathy in The Netherlands |
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| المؤلفون: | Michiel Dalinghaus, Tammo Delhaas, Ad J.J.C. Bogers, Gideon J. du Marchie Sarvaas, Gijs van Ingen, Gabriëlle G. van Iperen, M. Van Osch-Gevers, Ad P. C. M. Backx, Lukas A. J. Rammeloo, Ronald B. Tanke, Willem A. Helbing, Arend D. J. ten Harkel, Susanna L. den Boer |
| المساهمون: | Pediatrics, Otorhinolaryngology and Head and Neck Surgery, Cardiothoracic Surgery, Biomedische Technologie, RS: CARIM - R2 - Cardiac function and failure, RS: MHeNs - R3 - Neuroscience, Cardiology, Paediatric Cardiology, Pediatric surgery, ICaR - Heartfailure and pulmonary arterial hypertension |
| المصدر: | Journal of Heart and Lung Transplantation, 34(7), 963-969 Journal of Heart and Lung Transplantation, 34, 963-9 Journal of Heart and Lung Transplantation, 34(7), 963-969. Elsevier Inc. Journal of Heart and Lung Transplantation, 34(7), 963-969. Elsevier Science den Boer, S L, van Osch-Gevers, M, van Ingen, G, Sarvaas, G J D, van Iperen, G G, Tanke, R B, Backx, A P C M, ten Harkel, A D J, Helbing, W A, Delhaas, T, Bogers, A J J C, Rammeloo, L A J & Dalinghaus, M 2015, ' Management of children with dilated cardiomyopathy in The Netherlands: Implications of a low early transplantation rate ', Journal of Heart and Lung Transplantation, vol. 34, no. 7, pp. 963-969 . https://doi.org/10.1016/j.healun.2015.01.980 Journal of heart and lung transplantation, 34(7), 963-969. Elsevier USA Journal of Heart and Lung Transplantation, 34(7), 963-969. Elsevier USA Journal of Heart and Lung Transplantation, 34, 7, pp. 963-9 Journal of Heart and Lung Transplantation, 34(7), 963-969. ELSEVIER SCIENCE INC |
| بيانات النشر: | ELSEVIER SCIENCE INC, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, Pediatrics, Time Factors, medicine.medical_treatment, Cardiomyopathy, CHILDHOOD, heart failure, heart transplantation, DISEASE, law.invention, law, Risk Factors, Registries, Child, Netherlands, CARDIOLOGY, Heart transplantation, OUTCOMES, Incidence, Hazard ratio, Intensive care unit, Tissue Donors, CHRONIC HEART-FAILURE, Survival Rate, Child, Preschool, Cohort, SURVIVAL, Female, pediatric cardiology, TRIAL, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Cardiomyopathy, Dilated, medicine.medical_specialty, Myocarditis, Adolescent, Waiting Lists, METOPROLOL, Risk Assessment, medicine, Humans, Risk factor, Retrospective Studies, Transplantation, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Infant, medicine.disease, EXPERIENCE, Surgery, business, cardiomyopathy |
| الوصف: | BACKGROUND: The policy for listing and transplant for children with dilated cardiomyopathy (DCM) in The Netherlands has been conservative because of low donor availability. The effects of this policy on outcome are reported.METHODS: This was a multicenter, nationwide study performed in 148 children with DCM. The primary outcome was death or heart transplant.RESULTS: Overall, 43 patients (29%) died or were transplanted. Within 1 year of diagnosis, 21 patients died, and only 4 underwent transplantation (3 on mechanical circulatory support). The I-year survival was 85% (95% confidence interval [CI] = 79-91), and 5-year survival was 84% (95% CI = 78-90). Transplantation-free survival at 1 year was 82% (95% CI = 75-88) and at 5 years was 72% (95% CI = 64-80). Within 1 year of diagnosis, with death as the main end-point (21 of 25, 84%), intensive care unit admission (hazard ratio = 2.6, p = 0.05) and mechanical circulatory support (hazard ratio = 3.2, p = 0.03) were risk factors (multivariable Cox analysis); inotropic support was longer in patients reaching an end-point. At >1 year after diagnosis, with transplantation as the main end-point (15 of 18, 83%), age >6 years (hazard ratio = 6.1, p = 0.02) was a risk factor. There were 56 (38%) children who recovered, 50% within 1 year of diagnosis. Recovery was associated with younger age; was similar in patients with myocarditis (43%) and idiopathic disease (41%); and was similar in patients initially admitted to the intensive care unit, admitted to the ward, or treated as outpatients.CONCLUSIONS: The transplantation rate in our cohort in the first year was low, with 1-year and 5-year survival rates similar to other cohorts. Our results suggest that a conservative approach to list children for transplantation early after presentation may be justifiable except for patients with prolonged intensive care unit or mechanical circulatory support. (C) 2015 International Society for Heart and Lung Transplantation. All rights reserved. |
| اللغة: | English |
| تدمد: | 1557-3117 1053-2498 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a28efa20e630cf8374eddfb7191de8b3 https://research.rug.nl/en/publications/16ea9d87-b4e7-4980-883f-88aa0f8f9f7e |
| حقوق: | RESTRICTED |
| رقم الأكسشن: | edsair.doi.dedup.....a28efa20e630cf8374eddfb7191de8b3 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 15573117 10532498 |
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