Progress in Pediatric Cardiology | 2021
When and how does dilated cardiomyopathy recover in children?
Abstract
Abstract Much has been learned since the 1980s regarding the epidemiology, etiology, and outcomes of children with dilated cardiomyopathy (DCM). However, relatively little is understood about myocardial recovery in pediatric DCM. A purpose of the Fifth International Conference on Childhood Cardiomyopathy was to update researchers and clinicians with interests in pediatric cardiomyopathy and heart failure on recent findings in myocardial recovery in DCM and to identify gaps for future studies. Key questions addressed included: Alexander et al. (2013) [ 1 ] when does pediatric DCM recover; Moore et al. (2014) [ 2 ] what are the predictors of recovery; Ciuca et al. (2019) [ 3 ] what are the clinical features of recovery; and (Everitt et al., 2014 [ 4 ]) what are clinical and research gaps? More children with DCM are surviving without heart transplant in the current era of heart failure management, but the rate of recovery in these survivors is not widely known. Robust predictors for myocardial recovery in pediatric DCM are lacking. Future studies need to identify non-invasive markers of recovery to guide both prognostication at the time of diagnosis and to evaluate pharmaceuticals or device therapies that promote recovery. Moreover, there is a need for quality of life measures and patient-centered outcomes to understand the impact of waiting for myocardial recovery, particularly in children supported by ventricular assist devices or continuous inotropes. Lastly, studies of myocardial recovery in children need to include long-term outcomes and risk factors for heart failure recurrence or sudden death.