{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:28:00Z","timestamp":1787502480167,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The long\u2010term progression of idiopathic dilated cardiomyopathy (\n                      <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n                      ) in pediatric patients compared with adult patients has not been previously characterized. In this study, we compared outcome and long\u2010term progression of pediatric and adult\n                      <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n                      populations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Between 1988 and 2014, 927\n                      <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n                      patients were consecutively enrolled. The pediatric population (aged &lt;18\u00a0years at enrollment) included 47 participants (5.1%). At presentation, the pediatric population compared with adult patients had a significantly increased occurrence of familial forms (\n                      <jats:italic>P<\/jats:italic>\n                      =0.03), shorter duration of heart failure (\n                      <jats:italic>P<\/jats:italic>\n                      =0.04), lower systolic blood pressure (\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), decreased presence of left bundle\u2010branch block (\n                      <jats:italic>P<\/jats:italic>\n                      =0.001), and increased left ventricular ejection fraction (\n                      <jats:italic>P<\/jats:italic>\n                      =0.03). Despite these baseline differences, long\u2010term longitudinal trends of New York Heart Association class\n                      <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\n                      to\n                      <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n                      , left ventricular dimensions, left ventricular ejection fraction, and restrictive filling pattern were similar between the 2 populations. Regarding survival analysis, because of the size difference between the 2 populations, we compared the pediatric population with a sample of adult patients randomly matched using the above\u2010mentioned baseline differences in a 3:1 ratio (141 adult versus 47 pediatric patients). During a median follow\u2010up of 110\u00a0months, survival free from heart transplantation was significantly lower among pediatric patients compared with adults (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Furthermore, pediatric age (ie, &lt;18\u00a0years) was found to be associated with an increasing risk of both death from pump failure and life\u2010threatening arrhythmias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Despite the pediatric\n                      <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n                      population having higher baseline left ventricular ejection fraction and similar long\u2010term echocardiographic progression compared with the adult\n                      <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n                      population, the pediatric\n                      <jats:styled-content style=\"fixed-case\">DCM<\/jats:styled-content>\n                      patients had worse cardiovascular prognosis.\n 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