Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
<b>Background:</b> This study aimed to develop a predictive model to assess risk factors and prognoses in pediatric patients with dilated cardiomyopathy (DCM). <b>Methods:</b> A total of 233 pediatric patients with DCM who were hospitalized between January 2019 and June 2024...
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MDPI AG
2025-07-01
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| Series: | Children |
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| author | Bowen Xu Yue Yuan Lu Gao Zhiyuan Wang Zhenyu Lv Wen Yu Hongfang Jin Zhen Zhen Zhihui Zhao Jia Na Aihua Hu Yanyan Xiao |
| author_facet | Bowen Xu Yue Yuan Lu Gao Zhiyuan Wang Zhenyu Lv Wen Yu Hongfang Jin Zhen Zhen Zhihui Zhao Jia Na Aihua Hu Yanyan Xiao |
| author_sort | Bowen Xu |
| collection | DOAJ |
| description | <b>Background:</b> This study aimed to develop a predictive model to assess risk factors and prognoses in pediatric patients with dilated cardiomyopathy (DCM). <b>Methods:</b> A total of 233 pediatric patients with DCM who were hospitalized between January 2019 and June 2024 were enrolled. The children were followed up and categorized into two groups: the death/heart transplantation (D/HT) group and the non-D/HT group. Univariate and multivariate analyses identified risk factors. A nomogram model and a scoring system were developed. The performance of these models was evaluated using the H-L test, ROC analysis, and internal validation. <b>Results:</b> The results demonstrated that the age of onset, cardiac functional classification III–IV, moderate-to-severe mitral regurgitation, low voltage in limb leads on an ECG, and the need for vasoactive drugs are independent predictors of D/HT risk in children with DCM. A nomogram model was developed, achieving an AUC of 0.804 (95% CI: 0.734–0.874), a sensitivity of 80.3%, and a specificity of 66.7%. A scoring system was established: 1 point for age of onset, 10 points for cardiac functional classification III–IV, 2.5 points for moderate-to-severe mitral regurgitation, 4 points for low voltage in limb leads on an ECG, 3 points for the need for vasoactive drugs, or 0 points if none of these criteria were met. When the cumulative score was ≥ 13.25, the sensitivity and specificity increased to 68.9% and 73.9%, respectively. <b>Conclusions:</b> We developed both a nomogram and a scoring system model, which are capable of rapidly and accurately predicting the risk of D/HT in children with DCM. |
| format | Article |
| id | doaj-art-924ceb4fc14f4d2bb5edafea7e151efa |
| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
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| series | Children |
| spelling | doaj-art-924ceb4fc14f4d2bb5edafea7e151efa2025-08-20T02:45:38ZengMDPI AGChildren2227-90672025-07-0112788010.3390/children12070880Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart TransplantationBowen Xu0Yue Yuan1Lu Gao2Zhiyuan Wang3Zhenyu Lv4Wen Yu5Hongfang Jin6Zhen Zhen7Zhihui Zhao8Jia Na9Aihua Hu10Yanyan Xiao11Department of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing 100034, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaPediatric Chronic Disease Management Center, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, China<b>Background:</b> This study aimed to develop a predictive model to assess risk factors and prognoses in pediatric patients with dilated cardiomyopathy (DCM). <b>Methods:</b> A total of 233 pediatric patients with DCM who were hospitalized between January 2019 and June 2024 were enrolled. The children were followed up and categorized into two groups: the death/heart transplantation (D/HT) group and the non-D/HT group. Univariate and multivariate analyses identified risk factors. A nomogram model and a scoring system were developed. The performance of these models was evaluated using the H-L test, ROC analysis, and internal validation. <b>Results:</b> The results demonstrated that the age of onset, cardiac functional classification III–IV, moderate-to-severe mitral regurgitation, low voltage in limb leads on an ECG, and the need for vasoactive drugs are independent predictors of D/HT risk in children with DCM. A nomogram model was developed, achieving an AUC of 0.804 (95% CI: 0.734–0.874), a sensitivity of 80.3%, and a specificity of 66.7%. A scoring system was established: 1 point for age of onset, 10 points for cardiac functional classification III–IV, 2.5 points for moderate-to-severe mitral regurgitation, 4 points for low voltage in limb leads on an ECG, 3 points for the need for vasoactive drugs, or 0 points if none of these criteria were met. When the cumulative score was ≥ 13.25, the sensitivity and specificity increased to 68.9% and 73.9%, respectively. <b>Conclusions:</b> We developed both a nomogram and a scoring system model, which are capable of rapidly and accurately predicting the risk of D/HT in children with DCM.https://www.mdpi.com/2227-9067/12/7/880dilated cardiomyopathydeathheart transplantationpredictive modelchildren |
| spellingShingle | Bowen Xu Yue Yuan Lu Gao Zhiyuan Wang Zhenyu Lv Wen Yu Hongfang Jin Zhen Zhen Zhihui Zhao Jia Na Aihua Hu Yanyan Xiao Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation Children dilated cardiomyopathy death heart transplantation predictive model children |
| title | Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation |
| title_full | Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation |
| title_fullStr | Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation |
| title_full_unstemmed | Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation |
| title_short | Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation |
| title_sort | prognosis of pediatric dilated cardiomyopathy nomogram and risk score models for predicting death heart transplantation |
| topic | dilated cardiomyopathy death heart transplantation predictive model children |
| url | https://www.mdpi.com/2227-9067/12/7/880 |
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