Heart Stiffening in Pediatric Dilated Cardiomyopathy: Causes of Severity

Noor Mohammad Noori; Alireza Teimouri

doi:10.18502/jthc.v19i2.16201

Noor Mohammad Noori Department of Pediatrics, School of Medicine, Children and Adolescents Health Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Ali Ibne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
Alireza Teimouri Children and Adolescents Health Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Ali Ibne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.

DOI: https://doi.org/10.18502/jthc.v19i2.16201

Keywords: Vascular stiffness; Cardiomyopathy, dilated; Children

Abstract

Background: Cardiomyopathy, characterized by heart stiffness, can lead to heart failure. This study aimed to investigate aortic stiffness in children with dilated cardiomyopathy (DCM) to better understand its contribution to disease severity.

Methods: This case-control study compared 48 children with DCM with 96 healthy children over a 10-year period starting in 2011. Aortic strain, aortic stiffness index, aortic distensibility, and pressure strain elastic modulus were measured. These parameters, along with several echocardiographic measures, were compared between the DCM and control groups. Statistical analyses were performed using SPSS 18, with a significance threshold set at a P value below 0.05.

Results: The participants included 57.6% boys, with 58.3% in the DCM group and 57.35% in the control group (χ²=0.014, P=0.905). The age range was 2 to 18 years, with mean ages of 11.08±4.63 years for the DCM group and 10.77±2.82 years for the control group (P=0.691). Significant differences between groups were observed in aortic distensibility (P=0.004), aortic stiffness β index (P=0.001), and pressure strain elastic modulus (P=0.004). Post-treatment analyses based on ejection fraction and fractional shortening cutoffs indicated no changes in elasticity parameters except for the aortic stiffness β index, which varied according to the Ross classification.

Conclusion: Children with DCM exhibited reduced aortic strain and aortic distensibility, as well as elevated aortic stiffness β index and pressure strain elastic modulus