Title (english) Cardiomyopathies in children – Current opinions and our experiences Croatian retrospective epidemiological study 1988-2016
Title (croatian) Kardiomiopatije u djece – Današnja stajališta i naša iskustva Hrvatska retrospektivna epidemiološka studija 1988. – 2016.
Author Ivan Malčić
Author Dražen Belina
Author Anamarija Slišković
Author Dorotea Bartoniček
Author Marija Jelušić
Author Dalibor Šarić
Author Danijela Petković Ramadža
Author Ivan Lehman
Author Dražen Jelašić
Author Božidar Ferek-Petrić
Author Domagoj Kifer
Author Darko Anić
Author's institution University of Rijeka Faculty of Medicine (Department of Internal Medicine)
Author's institution University of Rijeka Faculty of Medicine (Department of Pediatrics)
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Abstract (english) Introduction: Cardiomyopathies (CM) account for 3-5% of patients in the care of pediatric cardiologists. They are found in all age groups, from fetal to adolescent age, and along with cardiology, teams from several other pediatric subspecialties (neurology, metabolism, genetics) are also included. New findings have led to a high survival rate. Goal: The primary goal is to present CM as an important part in the work of pediatric cardiologist through an elaborate epidemiological study, current classifications, the latest diagnostic methods and treatments,
as well as the intertwining with other subspecialties. The secondary goal is to show that CM are no longer “uncommon, insignificant and terminal”, but are common, significant and treatable diseases. Results: From January 1988 to December 2016 (28 years) in the Referral Center for Pediatric Cardiology, Department of Pediatrics, Clinical Hospital Centre, 315 patients were diagnosed with cardiomyopathy,183 males (58.1%) and 132 females (41.9%). In three different periods (10 , 12 and six years) a classification from 1996 was used (10). All three periods have features of a population study, whereas the latter two also have features of an epidemiological study. In all three periods there was a predominance of dilated cardiomyopathies (DCM) (42.5%) , followed by hypertrophic cardiomyopathies (HCM) (37.1%) and restrictive cardiomyopathies (RCM) (6.7%) . Their relative relations were in constant balance. A significant increase of some entity forms, arrhythmogenic right ventricular cardiomyopathies (ARVCM) and non-compaction cardimyopathies (NCCM) has been observed, from 5.8% (1988-1998) to 16.2% (2010-2016). Owing to advances in diagnostic methods, number of unclassified CM has been decreasing significantly. The cause remained unknown in only 24.4% of DCM patients, and in 18.8% of HCM patients. In the last 18 years the mortality rate of 7.4% (14/194) has been recorded, 50% (7/14) due to DCM. That is the result of teamwork, targeted medical therapy, electrotherapy (electrical stimulation - ES, cardiac resynchronisation - CRS, implantable cardioverter defibrilator - ICD) and surgical therapy (Morrow, pulmonary artery banding - PAB), including heart transplantaton since 2011 (8 patients). Conclusion: Cardiomyopathies are after congenital heart defects the most severe diseases under care of pediatric cardiologists. They require fluent teamwork of several expert groups, and mastering of numerous diagnostic and therapeutic methods. Dilated cardiomyopathies are the most common cause of death and the indication for heart transplatation in children.
Abstract (croatian) Uvod: Na kardiomiopatije (KM) otpada 3 – 5% svih bolesnika za koje se skrbe pedijatrijski kardiolozi. Nalaze se u svim dobnim skupinama, od fetalne do adolescentne dobi, a u timskom radu obuhvaćaju uz kardiologiju više pedijatrijskih supspecijalnosti (neurologija, metabolizam, genetika). Zbog novih spoznaja i mogućnosti liječenja stupanj preživljenja sve je viši. Cilj: Primarni je cilj prikazati KM-e opsežnom retrospektivnom epidemiološkom studijom prema suvremenoj klasifikaciji, primjenom najnovijih dijagnostičkih metoda i terapijskih pristupa te prožimanjem s ostalim supspecijalnostima. Sekundarni je cilj pokazati da kardiomiopatije više nisu „rijetke,
nevažne i neizlječive“, nego su česte, važne i lječive. Rezultati studije: U razdoblju od siječnja 1988. do prosinca 2016. (28 godina) u Referentnom centru za pedijatrijsku kardiologiju Klinike za pedijatriju KBC-a Zagreb hospitalizirano je 315 bolesnika s dijagnozom kardiomiopatije, 183 muškog (58,1%) i 132 ženskog (41,9%) spola. U tri različita razdoblja (10 godina, 12 godina, 6 godina) služili smo se klasifikacijom KM-a iz 1996. godine. Sva tri razdoblja imaju obilježja populacijske, a posljednja dva imaju obilježja i kliničke epidemiološke studije. U sva tri razdoblja najčešća je dilatacijska kardiomiopatija (DKM) (42,5%), a slijede hipertrofična (HKM) (37,1%) i restrikcijska (RKM) (6,7%). Njihovi su relativni odnosi u stalnoj ravnoteži. Uočava se znatan porast entitetskih oblika: aritmogena desnoventrikularna kardiomiopatija (ADVKM) i nekompaktna kardiomiopatija (NKKM), i to od 5,8% (1988. – 1998.) na 16,2% (2010. – 2016.). Smanjen je broj KM-a nepoznata uzroka: kod DKM-a 24,4%, a kod HKM-a tek 18,8%. U posljednjih 18 godina zabilježili smo smrtnost od 7,4% (14/194), od čega 50% (7/14) otpada na DKM. Rezultat je to timskog rada, ciljane medikamentne terapije, elektroterapije (elektrostimulator – ES, srčana resinkronizacija – CRS, implantabilni kardioverterski defibrilator – ICD) i kardiokirurške terapije (operacija prema Morrowu, zaomčavanje (engl. banding) plućne arterije – PAB), uključujući i presadbu srca od 2011. godine (8 bolesnika). Zaključak: Kardiomiopatije su nakon prirođenih srčanih grješaka najteže bolesti u skrbi pedijatrijskog kardiologa, nalažu skladan timski rad više skupina stručnjaka te svladavanje brojnih dijagnostičkih i terapijskih metoda. Dilatacijske kardiomiopatije najčešći su uzrok smrti i najčešća indikacija za presadbu srca u djece.
Keywords (english)
CARDIOMYOPATHIES – classification, diagnosis, epidemiology, therapy
CARDIOMYOPATHY, DILATED – diagnosis, epidemiology, etiology, therapy
CARDIOMYOPATHY, HYPERTROPHIC diagnosis, epidemiology, etiology, therapy
CARDIOMYOPATHY, RESTRICTIVE – diagnosis, epidemiology, etiology, therapy
ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA - diagnosis, epidemiology, etiology, therapy
ELECTRIC STIMULATION THERAPY
CARDIAC SURGICAL PROCEDURES
HEART TRANSPLATATION
TREATMENT OUTCOME
CROATIA – epidemiology
RESTROSPECTIVE STUDIES
CHILD
Keywords (croatian)
KARDIOMIOPATIJE – dijagnoza, epidemiologija, klasifikacija, liječenje
DILATACIJSKA KARDIOMIOPATIJA – epidemiologija, etiologija, dijagnoza, liječenje
HIPERTROFIČNA KARDIOMIOPATIJA – epidemiologija, etiologija, dijagnoza, liječenje
RESTRIKCIJSK KARDIOMIOPATIJA – epidemiologija, etiologija, dijagnoza, liječenje
ARITMOGENA KARDIOMIOPATIJA DESNE KLIJETKE – epidemiologija, etiologija, dijagnoza, liječenje
ELEKTROTERAPIJA
KARDIOKIRURŠKI ZAHVATI
TRANSPLANTACIJA SRCA
ISHOD LIJEČENJA
HRVATSKA – epidemiologija
RETROSPEKTIVNE STUDIJE
DJECA
Language english
Language croatian
Publication type Scientific paper - Original scientific paper
Publication status Published
Peer review Peer review
Publication version Published version
Journal title Liječnički vjesnik
Numbering vol. 141, no. 3-4, p. 68
p-ISSN 0024-3477
e-ISSN 1849-2177
DOI https://doi.org/10.26800/LV-141-3-4-11
URN:NBN urn:nbn:hr:184:629615
Publication 2019
Document URL https://hrcak.srce.hr/220209
Type of resource Text
Access conditions Open access
Terms of use
Created on 2022-02-09 09:35:11