Elevated Heart Rate and Survival in Children With Dilated Cardiomyopathy: A Multicenter Study From the Pediatric Cardiomyopathy Registry.

TitleElevated Heart Rate and Survival in Children With Dilated Cardiomyopathy: A Multicenter Study From the Pediatric Cardiomyopathy Registry.
Publication TypeJournal Article
Year of Publication2020
AuthorsRossano JW, Kantor PF, Shaddy RE, Shi L, Wilkinson JD, Jefferies JL, Czachor JD, Razoky H, Wirtz HS, Depre C, Lipshultz SE
JournalJ Am Heart Assoc
Volume9
Issue15
Paginatione015916
Date Published2020 Aug 04
ISSN2047-9980
Abstract

Background In adults with heart failure, elevated heart rate is associated with lower survival. We determined whether an elevated heart rate was associated with an increased risk of death or heart transplant in children with dilated cardiomyopathy. Methods and Results The study is an analysis of the Pediatric Cardiomyopathy Registry and includes baseline data, annual follow-up, and censoring events (transplant or death) in 557 children (51% male, median age 1.8 years) with dilated cardiomyopathy diagnosed between 1994 and 2011. An elevated heart rate was defined as 2 or more SDs above the mean heart rate of children, adjusted for age. The primary outcomes were heart transplant and death. Heart rate was elevated in 192 children (34%), who were older (median age, 2.3 versus 0.9 years; <0.001), more likely to have heart failure symptoms (83% versus 67%; <0.001), had worse ventricular function (median fractional shortening score, -9.7 versus -9.1; =0.02), and were more often receiving anticongestive therapies (96% versus 86%; <0.001) than were children with a normal heart rate. Controlling for age, ventricular function, and cardiac medications, an elevated heart rate was independently associated with death (adjusted hazard ratio [HR] 2.6; <0.001) and with death or transplant (adjusted HR 1.5; =0.01). Conclusions In children with dilated cardiomyopathy, elevated heart rate was associated with an increased risk of death and cardiac transplant. Further study is warranted into the association of elevated heart rate and disease severity in children with dilated cardiomyopathy and as a potential target of therapy.

DOI10.1161/JAHA.119.015916
Alternate JournalJ Am Heart Assoc
PubMed ID32750307