Clinical Characteristics Of Tachycardia-ind Uced Cardiomyopathy In15Children

Objective: Discussion the clinical features, diagnosis, treatment andprognosis of tachycardia-induced cardiomyopathy(TIC), and comparing itwith Dilated Cardiomyopathy (DCM) to improve awareness, diagnosis thetreatment of TIC.Methods: Collected374cases of arrhythmia and53cases ofidiopathic dilated cardiomyopathy from January2007to December2013inour hospital in-patient department. And there were15cases ofTachycardia-induced cardiomyopathy,24cases of Tachycardia, dilatedcardiomyopathy merger. Retrospective analysis and comparison with thedata for the two groups of children in general, clinical manifestations,cardiac function, chest radiograph, electrocardiogram,24-hour ambulatoryelectrocardiogram, echocardiogram, treatment, efficacy and prognosis.Results: The age of TIC and DCM group were2.7±3.3years old,7.9±4.0years old, the difference was statistically significant (t=4.47,P<0.01). However, the difference between two groups was not statisticallysignificant (P>0.05) about the sex, initial duration, modified Ross scoreand initial hospitalization time. Two clinical manifestations are roughlysimilar, they all suffered shortness of breath may occur after the event tiredheart weakness, sweating, palpitations, chest tightness, pale, dizziness.Most of the children were suffered outside the heart symptoms cough, fever,vomiting, abdominal pain, liver enlargement mostly, arrhythmia, low heartsound blunt, heart murmurs and other signs; both groups were hospitalizedheart rate189±26.4beats/min,135.4±35.8beats/min, The difference with two groups were statistically significant (t=5.97, P <0.01). TIC groupmost suffered with atrial tachycardia (8cases,53.3%), while the DCMgroup most suffered sinus tachycardia with frequently prematureventricular contractions or premature atrial-based (10cases,41.6%); LVEF,LVFS of TIC groups were significantly higher than DCM before treatment,LVEDD of TIC group was significantly less than the DCM group (P<0.05).The heart rate, modified Ross score, LVEF, LVFS significantly improved(P<0.5) than before. The difference was statistically significant, the valueof LVEDD is not significant changed compared with the previous (P>0.05),the difference was not statistically significant. Followed-up is: heartfunction of14patients (100%) with TIC group was normal, and10cases(71.4%) to expand the heart were recovered, there was no death. Sevencases of the DCM group were lost, seven cases (41.2%)kids died, and3cases (30%) of heart function were recovered,10cases (100%) were stillsignificantly expanded, two groups were statistically significant (P <0.05).Conclusions: Tachycardia-induced cardiomyopathy occurs during thetime of preschool, and the process of disease is short during the initialvisitation, cardiac function and cardiac extension is less than DCM in firstvisitation. Cardiac function is recovered significantly after restoration ofsinus rhythm and the control of ventricular rate timely; finally, patientswere completely recovered while enlarged heart recovery is relatively slow.Two groups have many similarities in clinical presentation,echocardiography and chest X-ray characteristic aspects, and sometimesthe identification is more difficult, for simultaneous tachycardia, theventricular dysfunction and heart enlargement of children when we needtake TIC into consideration. Heart function, heart size and follow-up ECGare helpful to the diagnosis of DCM. There is a better prognosis abouteffective cardioversion, ventricular rate control and refractory heart failure after-treatment.