Pediatric Dilated Cardiomyopathy Clinical Trial
Official title:
A Study of Impact of Anemia on Morbidity and Mortality in Children With Dilated Cardiomyopathy
Dilated cardiomyopathy is a heart muscle disorder characterized by systolic dysfunction and
dilation of the left or both ventricles.Dilated cardiomyopathy can develop in people of any
age or ethnicity, although it is more common in male than female persons occurring at a ratio
of about three to one in male to female persons.
Dilated cardiomyopathy is the predominant cause of cardiomyopathy in pediatric populations.
Annual incidence in pediatric populations has been reported to be much lower than one to one
hundred seventy thousand in the United States and one to one hundred forty thousand in
Australia.
Although pediatric dilated cardiomyopathy has a lower annual incidence than adult dilated
cardiomyopathy, the outcome for pediatric dilated cardiomyopathy patients is particularly
severe.
Dilated cardiomyopathy is the most frequent cause of heart transplantation in pediatric
patients. Data from international pediatric dilated cardiomyopathy registries indicate that
the rates of death or heart transplantation over one and five year periods were thirty one
percent and forty six percent, respectively.
Onset of dilated cardiomyopathy is usually insidious but may be acute in as many at twenty
five percent of patients. Approximately fifty percent of patients with dilated cardiomyopathy
have a history of preceding viral illness.
The clinical diagnosis of dilated cardiomyopathy is made from history, physical examination,
and noninvasive testing. The initial clinical manifestations of dilated heart failure are
generally those of respiratory distress secondary to congestion of the pulmonary and systemic
venous circulations.
Pallor, irritability, diaphoresis, tachypnea, easy fatigability are characteristics.
Failure to grow may also occur. In older patients, a history of orthopnea, nocturnal cough,
and dyspnea provoked by minimal activity can be elicited and generally precede evidence of
systemic venous congestion. In rapidly progressive disease, dominant symptoms are often
abdominal distention, right upper quadrant pain, and nausea. Less often, initial symptoms in
childhood include arrhythmias, syncope, neurologic problems (seizures or delayed
development), vomiting, abdominal distention, or fever.
Although as many as fifty percent of children with cardiomyopathy and heart failure give a
history of a nonspecific febrile illness within three months of presentation, no evidence of
myocarditis can usually be found on biopsy.'Physical signs vary with the stage of the
disease.
Signs of congestive heart failure are frequent, and include tachypnea,tachycardia,
diaphoresis, hepatomegaly, pallor, and, in advanced cases, hypotension and shock.
Failure to thrive may be present if, heart failure has been long standing. Patients are
generally not cyanotic. Wheezing may be heard; however, rales are infrequent, especially in
infants.
Neck vein distension is common, the external jugular crest reflecting mean right atrial
pressure, the internal jugular exhibiting a prominent V wave indicative of tricuspid
regurgitation.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT02847585 -
Potential Role of Water-soluble Ubiquinol in Complementary Therapy for Pediatric Dilated Cardiomyopathy
|
N/A |