{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:35:15Z","timestamp":1780637715630,"version":"3.54.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,1,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Pediatric dilated cardiomyopathy often leads to death or cardiac transplantation. We sought to determine whether changes in left ventricular (LV) end\u2010diastolic dimension (LVEDD), LV end\u2010diastolic posterior wall thickness, and LV fractional shortening (LVFS) over time may help predict adverse outcomes.<\/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              We studied children up to 18\u2009years old with dilated cardiomyopathy, enrolled between 1990 and 2009 in the Pediatric Cardiomyopathy Registry. Changes in LVFS, LVEDD, LV end\u2010diastolic posterior wall thickness, and the LV end\u2010diastolic posterior wall thickness:LVEDD ratio between baseline and follow\u2010up echocardiograms acquired \u22481\u2009year after diagnosis were determined for children who, at the 1\u2010year follow\u2010up had died, received a heart transplant, or were alive and transplant\u2010free. Within 1\u2009year after diagnosis, 40 (5.0%) of the 794 eligible children had died, 117 (14.7%) had undergone cardiac transplantation, and 585 (73.7%) had survived without transplantation. At diagnosis, survivors had higher median LVFS and lower median LVEDD\n              <jats:italic>Z<\/jats:italic>\n              scores. Median LVFS and LVEDD\n              <jats:italic>Z<\/jats:italic>\n              scores improved among survivors (\n              <jats:italic>Z<\/jats:italic>\n              score changes of +2.6 and \u22121.1, respectively) but remained stable or worsened in the other 2 groups. The LV end\u2010diastolic posterior wall thickness:LVEDD ratio increased in survivors only, suggesting beneficial reverse LV remodeling. The risk for death or cardiac transplantation up to 7\u2009years later was lower when LVFS was improved at 1\u2009year (hazard ratio [HR], 0.83;\n              <jats:italic>P<\/jats:italic>\n              =0.004) but was higher in those with progressive LV dilation (HR, 1.45;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Progressive deterioration in LV contractile function and increasing LV dilation are associated with both early and continuing mortality in children with dilated cardiomyopathy. Serial echocardiographic monitoring of these children is therefore indicated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT00005391.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.022557","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T11:18:18Z","timestamp":1705058298000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Progressive Left Ventricular Remodeling for Predicting Mortality in Children With Dilated Cardiomyopathy: The Pediatric Cardiomyopathy Registry"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4244-1563","authenticated-orcid":false,"given":"Paul F.","family":"Kantor","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital Los Angeles and Keck School of Medicine of USC Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Shi","sequence":"additional","affiliation":[{"name":"New England Research Institutes Watertown MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-0947","authenticated-orcid":false,"given":"Steven D.","family":"Colan","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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