{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:14:26Z","timestamp":1780636466045,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Pediatric dilated cardiomyopathy (DCM) is a primary cause of heart failure, highlighting the urgent need for effective prognostic markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a single-center retrospective study involving 145 children diagnosed with DCM, with a median follow-up period of 4.0 months (interquartile range: 6.2\u2013108.4 months). The relationship between serum uric acid (SUA) levels and all-cause mortality was assessed using Kaplan\u2013Meier survival curves, multivariate Cox proportional hazard models, and restricted cubic spline (RCS) models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 145 children with DCM (median age 5.7 years; 61.4% male), 45 (31%) died within 1 year, and 65 (44.8%) died during the maximum follow-up period. In adjusted multivariate Cox regression models, each log2 SUA increase was linked to a higher risk of 1-year mortality [hazard ratio (HR), 2.66; 95% confidence interval (CI), 1.41\u20135.01] and overall mortality (HR, 1.97; 95% CI, 1.15\u20133.37). The highest SUA tertile showed a greater risk of mortality at 1 year (HR, 4.26; 95% CI: 1.5\u201312.06) and during the maximum follow-up (HR, 2.56; 95% CI: 1.06\u20136.16) compared with the lowest tertile. RCS models indicated an inverted L-shaped association between baseline SUA levels and overall mortality risk, with age-stratified analyses revealing a linear and U-shaped relationship in children \u226410 and &amp;gt;10 years, respectively. Further age-stratified analyses highlighted the modifying effect of age on this association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated SUA levels are a significant predictor of mortality in pediatric DCM, with a pronounced impact on children under 10 years of age. Therefore, SUA levels could serve as potential biomarkers for risk stratification in this population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1404755","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T10:16:20Z","timestamp":1721729780000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Uric acid elevation in pediatric patients with dilated cardiomyopathy and prediction of mortality"],"prefix":"10.3389","volume":"11","author":[{"given":"Yong","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyuan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongli","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusheng","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e015916","DOI":"10.1161\/jaha.119.015916","article-title":"Elevated heart rate and survival in children with dilated cardiomyopathy: a multicenter study from the pediatric cardiomyopathy registry","volume":"9","author":"Rossano","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.hfc.2010.05.002","article-title":"The pediatric cardiomyopathy registry and heart failure: key results from the first 15 years","volume":"6","author":"Wilkinson","year":"2010","journal-title":"Heart Fail Clin"},{"key":"B3","doi-asserted-by":"publisher","first-page":"771283","DOI":"10.3389\/fped.2021.771283","article-title":"Long-term outcomes and prognosticators of pediatric primary dilated cardiomyopathy in an Asian cohort","volume":"9","author":"Wang","year":"2021","journal-title":"Front Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2039","DOI":"10.1161\/circulationaha.113.002767","article-title":"Long-term outcomes of dilated cardiomyopathy diagnosed during childhood: results from a national population-based study of childhood cardiomyopathy","volume":"128","author":"Alexander","year":"2013","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1161\/cir.0000000000000682","article-title":"Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American Heart Association","volume":"140","author":"Lipshultz","year":"2019","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1198924","DOI":"10.3389\/fpubh.2023.1198924","article-title":"Analysis of the disease burden of cardiomyopathy in children aged 0\u201314 years in China from 1990 to 2019","volume":"11","author":"Kong","year":"2023","journal-title":"Front Public Health"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1002\/ehf2.12765","article-title":"Prognostic impacts of serum uric acid levels in patients with chronic heart failure: insights from the CHART-2 study","volume":"8","author":"Fujihashi","year":"2021","journal-title":"ESC Heart Fail"},{"key":"B8","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.ejim.2008.04.007","article-title":"Hyperuricemia in acute heart failure. 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