C-Reactive Protein in Dilated Cardiomyopathy

Dilated cardiomyopathy (DCM) is a heart muscle disorder defined by the presence of a dilated and poorly functioning left ventricle in the absence of abnormal loading conditions (hypertension, valve disease) or ischaemic heart disease sufficient to cause global systolic impairment. A 5 years old and 6 months old girl with unremarkable cardiac history hospitalized for congestive heart failure due to dilated cardiomyopathy concomitant with acute rheumatic feverandsporadic hereditary spherocytosis.Acute rheumatic fever diagnosed based on the presentation of carditis, fever, high erythrocyte sedimentation rate, C-Reactive Protein (+), and antistreptolysin titer O (+).DCM was diagnosed after echocardiography. Sporadic hereditary spherocytosis was diagnosed based on anamnesis of pale and jaundice, splenomegaly on physical examination, hemolytic anemia, reticulocytosis, spherosit (+). Both parents reveals normal hematologic finding and the osmotic resistance test showed increasing of osmotic fragility. Prognosis of this patient remains worse because of inadequateleft ventricle-right ventricle (LV-RV) function and highly increasing The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level.

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Anaemia is a predictor of early death or cardiac transplantation in children with idiopathic dilated cardiomyopathy

Cardiology in the Young ◽

10.1017/s1047951111001442 ◽

2011 ◽

Vol 22 (3) ◽

pp. 293-300 ◽

Cited By ~ 6

Author(s):

Issam Kammache ◽

Giovanni Parrinello ◽

Davide Marini ◽

Damien Bonnet ◽

Gabriella Agnoletti

Keyword(s):

Confidence Interval ◽

Dilated Cardiomyopathy ◽

Cardiac Transplantation ◽

Cox Model ◽

Early Death ◽

Hazard Ratio ◽

Idiopathic Dilated Cardiomyopathy ◽

C Reactive Protein ◽

Reactive Protein ◽

First Diagnosis

AbstractIntroductionThe aim of our study was to establish the prevalence and the prognostic value of haematological abnormalities in children with cardiac failure.Patients and methodsA series of 218 consecutive children with a first diagnosis of idiopathic dilated cardiomyopathy were retrospectively examined. Haematological evaluation was performed at first diagnosis. Death or cardiac transplantation was the main outcome measure.ResultsThe median age was 0.6 years, ranging from 1 day to 15.8 years and median follow-up was 2.65 years, ranging from 0 to 17.2 years. After a median interval of 0.2 years, ranging from 0 to 8.7 years, 56 patients died and 25 were transplanted. Event-free survival at 1 and 5 years was 68% (95% confidence interval, 63–75%) and 62% (95% confidence interval, 56–69%). Blood levels of haemoglobin less than 10 grams per decilitre, urea over 8 millimoles per litre, and C-reactive protein over 10 milligrams per litre were found in 24%, 20%, and 24% of patients, respectively. The log-rank test showed that haemoglobin (p = 0.000) and C-reactive protein (p = 0.021) were predictors of death or transplantation. In the multivariate Cox model, haemoglobin (hazard ratio = 0.735; confidence interval = 0.636–0.849; p = 0.000) and urea (hazard ratio = 1.083; confidence interval = 1:002–1:171; p = 0.045) were predictive of poor outcome. Cubic spline functions showed that the positive role of haemoglobin on survival was linear for values less than 12 grams per decilitre and null for values more than 12 grams per decilitre. Adaptive index models for risk stratification and Classification and Regression Tree analysis allowed to identify the cut-off values for haemoglobin (less than 10.2 grams per decilitre) and urea (more than 8.8 millimoles per litre), as well as to derive a predictor model.ConclusionsIn children with idiopathic dilated cardiomyopathy, anaemia is the strongest independent prognostic factor of early death or transplantation.

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