Prognostic value of cardiopulmonary exercise testing in children with dilated cardiomyopathy

For children with advanced heart failure, heart transplantation may be the only option. Some children may benefit from an earlier transplantation to avoid major complications and death, but it is difficult to know who they are. This project studies how exercise testing may help to better identify children who would most benefit from a heart transplantation, and therefore avoid early transplantation for those you would not.

In adults with dilated cardiomyopathy (DCM), cardiopulmonary exercise testing (CPET) provides key parameters that help identify patients at risk of deterioration. In children, studies on the prognostic value of CPET in DCM are small and the cut-off under which the risk is increased remains unclear.

This is a multicenter, retrospective cohort study. The targeted population comprises children <18 years of age with dilated cardiomyopathy who underwent an incremental CPET (either bicycle or treadmill) during their routine clinical follow-up between 2010 and 2018. The primary endpoint is a composite endpoint of death, hospitalization for worsening heart failure (needing intravenous inotropic support, mechanical ventilation, or mechanical circulatory support), or heart transplantation.

In the context of limited organ supply, it is crucial to find tools to better risk stratify these patients. CPET may be part of the answer in children, as it is in adults. Better risk stratification means better treatment allocation.

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