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Median follow-up was 2.1 years [IQR 0.8\u20134.3]. Twenty-three children recovered at a median of 0.6 years [IQR 0.5\u20131.4] after diagnosis, and 78 children had ongoing disease at the end of the study. Children who reached the SE could be distinguished from those who did not, based on the temporal evolution of four risk factors: stunting of length growth (\u22120.42 vs. \u22120.02 length Z-score per year, P &amp;lt; 0.001), less decrease in N-terminal pro-B-type natriuretic peptide (NT-proBNP) (\u22120.26 vs. \u22121.06 2log pg\/mL\/year, P &amp;lt; 0.01), no decrease in left ventricular internal diastolic dimension (LVIDd; 0.24 vs. \u22120.60 Boston Z-score per year, P &amp;lt; 0.01), and increase in New York University Pediatric Heart Failure Index (NYU PHFI; 0.49 vs. \u22121.16 per year, P &amp;lt; 0.001). When we compared children who reached the SE with those with ongoing disease (leaving out the children who recovered), we found similar results, although the effects were smaller. In univariate analysis, NT-proBNP, length Z-score, LVIDd Z-score, global longitudinal strain (%), NYU PHFI, and age &amp;gt;6 years at presentation (all P &amp;lt; 0.001) were predictive of adverse outcome. In multivariate analysis, NT-proBNP appeared the only independent predictor for adverse outcome, a two-fold higher NT-proBNP was associated with a 2.8 times higher risk of the SE (hazard ratio 2.78, 95% confidence interval 1.81\u20133.94, P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The evolution over time of NT-proBNP, LVIDd, length growth, and NYU PHFI identified a subgroup of children with dilated cardiomyopathy at high risk for adverse outcome. In this sample, with a limited number of endpoints, NT-proBNP was the strongest independent predictor for adverse outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13233","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T12:28:28Z","timestamp":1612787308000},"page":"1472-1481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Predicting Outcome in Children with Dilated Cardiomyopathy: The Use of Repeated Measurements of Risk Factors for Outcome"],"prefix":"10.1093","volume":"8","author":[{"given":"Marijke","family":"van der Meulen","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Erasmus MC, University Medical Center Rotterdam , Dr Molewaterplein 60, PO Box 2060, Rotterdam, 3000 CB ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"den Boer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Erasmus MC, University Medical Center Rotterdam , Dr Molewaterplein 60, PO Box 2060, Rotterdam, 3000 CB ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon J.","family":"du Marchie Sarvaas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, University of Groningen, University Medical Center Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nico","family":"Blom","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Department of Pediatric Cardiology, University of Leiden , Leiden ,","place":["The Netherlands"]},{"name":"Academic Medical Center, Department of Pediatric Cardiology, University of Amsterdam , Amsterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arend D.J.","family":"ten Harkel","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Department of Pediatric Cardiology, University of Leiden , Leiden ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans M.P.J.","family":"Breur","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, University of Utrecht, Wilhelmina Children's Hospital, University Medical Center Utrecht , Utrecht ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas A.J.","family":"Rammeloo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Free University of Amsterdam, Free University Medical Center , Amsterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Tanke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Radboud University Medical 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