[Non-compacted cardiomyopathy: clinical characteristics, evolution and prognostic data in childhood. Results of a multicenter study]. / Miocardiopatía no compactada: características clínicas, evolutivas y pronósticas en edad pediátrica. Resultados de un estudio multicéntrico.

INTRODUCTION: Non-compaction of the ventricular myocardium (NCVM) is a rare congenital heart disease. Heightened awareness has resulted in increased detection of the morphological features of NCVM in routine clinical practice. PATIENTS AND METHODS: Multicentre study including paediatric patients affected by NCVM according to the echocardiographic criteria of Chin and Jenni. RESULTS: A total of 29 patients were included, 15 female and 14 male, the median age at diagnosis was 5 years and 7 months (birth to 17 years). Sixteen patients (55%) presented as an isolated lesion, 8 (27.5%) had a ventricular septal defect, one of them associated with aortic coarctation, 3 (10%) had an inborn error of metabolism, 1 (3.5%) had Juvenile Idiopathic Arthritis and 1 (3.5%) has a syndrome being studied. The location of the trabeculae has been predominantly at the apex, but also affected the left ventricle free wall in 11 patients (40%) and right ventricle in 2 (7%). No complications were present in 12 patients (41%), with cardiac failure in 12 patients (41%), an implantable cardioverter defibrillator was placed for ventricular arrhythmias in 2 patients (7%), stroke, 1 patient (3,5%) and death, 2 patients (7%), both of them less than 6 months of age (P<.05). Median follow up was 12 months (2 months to 8 years). Current treatment includes carvedilol, ACEI's and ASA, and one patient is waiting for a cardiac transplantation. CONCLUSIONS: Early onset of symptoms is associated with a poor prognosis. Clinical and prognostic heterogeneity is described.

Miocardiopatía no compactada: características clínicas, evolutivas y pronósticas en edad pediátrica. Resultados de un estudio multicéntrico / Non-compacted cardiomyopathy: clinical characteristics, evolution and prognostic data in childhood. Results of a multicentre study

Introducción y objetivos: La miocardiopatía no compactada es una enfermedad congénita infrecuente pero su diagnóstico se está incrementando últimamente coincidiendo con un mejor conocimiento de la entidad. Pacientes y métodos: Estudio multicéntrico que incluye pacientes pediátricos diagnosticados de miocardiopatía no compactada según los criterios ecocardiográficos de Chin y Jenni. Resultados: Se incluyó a un total de 29 pacientes, 15 niñas y 14 niños, con una edad mediana al diagnóstico de 5,6 años (0-17). Dieciséis pacientes (55%) tienen una lesión aislada, 8 (27,5%) comunicación interventricular asociada (uno de ellos con coartación de aorta), 3 (10%) error innato del metabolismo, 1 (3,5%) artritis idiopática juvenil y 1 otros. La localización de las trabéculas ha sido predominantemente en el ápex, afectando también en 11 casos (40%) la pared libre del ventrículo izquierdo y en 2 (7%) el ventrículo derecho. La evolución ha sido buena en 12 pacientes (41%), insuficiencia cardiaca congestiva 12 (41%), arritmias ventriculares precisando implante de desfibrilador automático 2 (7%), accidente vascular cerebral 1 (3,5%) y fallecimiento 2 (7%), ambos menores de 6 meses de vida (p<0,05). El tiempo mediano de seguimiento ha sido de 12 meses (2 meses a 8 años). El tratamiento se basa en combinación farmacológica y un paciente está en lista de trasplante cardíaco. Conclusiones: Parece existir una relación entre el inicio precoz de la sintomatología y un peor pronóstico. Se describe una gran heterogeneidad clínica, evolutiva y pronóstica(AU)

Introduction: Non-compaction of the ventricular myocardium (NCVM) is a rare congenital heart disease. Heightened awareness has resulted in increased detection of the morphological features of NCVM in routine clinical practice. Patients and methods: Multicentre study including paediatric patients affected by NCVM according to the echocardiographic criteria of Chin and Jenni. Results: A total of 29 patients were included, 15 female and 14 male, the median age at diagnosis was 5 years and 7 months (birth to 17 years). Sixteen patients (55%) presented as an isolated lesion, 8 (27.5%) had a ventricular septal defect, one of them associated with aortic coarctation, 3 (10%) had an inborn error of metabolism, 1 (3.5%) had Juvenile Idiopathic Arthritis and 1 (3.5%) has a syndrome being studied. The location of the trabeculae has been predominantly at the apex, but also affected the left ventricle free wall in 11 patients (40%) and right ventricle in 2 (7%). No complications were present in 12 patients (41%), with cardiac failure in 12 patients (41%), an implantable cardioverter defibrillator was placed for ventricular arrhythmias in 2 patients (7%), stroke, 1 patient (3,5%) and death, 2 patients (7%), both of them less than 6 months of age (P<0.05). Median follow up was 12 months (2 months to 8 years). Current treatment includes carvedilol, ACEI‘s and ASA, and one patient is waiting for a cardiac transplantation. Conclusions: Early onset of symptoms is associated with a poor prognosis. Clinical and prognostic heterogeneity is described(AU)