{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:09:47Z","timestamp":1793750987458,"version":"4.6.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"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. Pediatr."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Dilated cardiomyopathy (DCM) is the most common childhood cardiomyopathy. The epidemiological profiles and prognosticators of clinical outcomes in Asian populations are not well elucidated.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Data of 104 children aged &amp;lt;18 years with a diagnosis of primary DCM from January 1990 to December 2019 in our institutional database were retrospectively investigated. Relevant demographic, echocardiographic, and clinical variables were recorded for analysis. A <jats:italic>P<\/jats:italic> &amp;lt;0.05 was considered statistically significant.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The median age at diagnosis was 1.4 years (interquartile range = 0.3\u20139.1 years), and 52.9% were males. During a median follow-up duration of 4.8 years, 48 patients (46.2%) were placed on the transplantation waitlist, and 52.1% of them eventually received heart transplants. An exceptionally high overall waitlist mortality rate was noted (27.1%), which was even higher (43.5%) if the diagnostic age was &amp;lt;3 years. The 1-, 5-, and 10-year transplant-free were 61.1, 48.0, and 42.8%. Age at diagnosis &amp;gt;3 years and severe mitral regurgitation at initial diagnosis were independent risk factors for death or transplantation (hazard ratios = 2.93 and 3.31, respectively; for both, <jats:italic>P<\/jats:italic> &amp;lt;0.001). In total, 11 patients (10.6%) experienced ventricular function recovery after a median follow-up of 2.5 (interquartile range = 1.65\u20135) years. Younger age at diagnosis was associated a higher probability of ventricular function recovery.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Despite donor shortage for heart transplantation and subsequently high waitlist mortality, our data from an Asian cohort indicated that transplant-free long-term survival was comparable with that noted in reports from Western populations. Although younger patients had exceptionally higher waitlist mortality, lower diagnostic age was associated with better long-term survival and higher likelihood of ventricular function recovery.<\/jats:p>","DOI":"10.3389\/fped.2021.771283","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T05:56:13Z","timestamp":1635832573000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Long-Term Outcomes and Prognosticators of Pediatric Primary Dilated Cardiomyopathy in an Asian 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