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Original Article
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Volume 348:1647-1655 April 24, 2003 Number 17
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The Incidence of Pediatric Cardiomyopathy in Two Regions of the United States
Steven E. Lipshultz, M.D., Lynn A. Sleeper, Sc.D., Jeffrey A. Towbin, M.D., April M. Lowe, M.S., E. John Orav, Ph.D., Gerald F. Cox, M.D., Ph.D., Paul R. Lurie, M.D., Kristina L. McCoy, R.N., Melissa A. McDonald, M.P.H., Jane E. Messere, R.N., and Steven D. Colan, M.D.

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ABSTRACT

Background Population-based data on the incidence of pediatric cardiomyopathy are rare because of the lack of large, prospective studies.

Methods Since 1996 the Pediatric Cardiomyopathy Registry sponsored by the National Heart, Lung, and Blood Institute has collected data on all children with newly diagnosed cardiomyopathy in New England and the Central Southwest region (Texas, Oklahoma, and Arkansas) of the United States. We report on all children in these regions who received this diagnosis between 1996 and 1999.

Results We identified 467 cases of cardiomyopathy, for an overall annual incidence of 1.13 per 100,000 children (95 percent confidence interval, 1.03 to 1.23). The incidence was significantly higher among infants younger than 1 year old than among children and adolescents who were 1 to 18 years old (8.34 vs. 0.70 per 100,000, P<0.001). The annual incidence of cardiomyopathy was lower among white children (upper-bound estimate, 1.06 cases per 100,000) than among black children (lower-bound estimate, 1.47 per 100,000; P=0.02) and higher among boys than among girls (1.32 vs. 0.92 per 100,000, P<0.001). The incidence also varied significantly by region: 1.44 cases per 100,000 in New England and 0.98 per 100,000 in the Central Southwest region (P<0.001). When categorized according to type, dilated cardiomyopathy made up 51 percent of the cases, hypertrophic cardiomyopathy 42 percent, and restrictive or other types 3 percent; 4 percent were unspecified. There was no significant difference in the incidence rates according to the year.

Conclusions The estimated incidence of pediatric cardiomyopathy in two large regions of the United States is 1.13 cases per 100,000 children. Most cases are identified at an early age, and the incidence varies according to sex, region, and racial or ethnic origin.


Source Information

From the Division of Pediatric Cardiology, Golisano Children's Hospital at Strong and University of Rochester Medical Center, and the Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, N.Y. (S.E.L., K.L.M., M.A.M.); the Department of Cardiology (S.E.L., J.E.M., S.D.C.) and the Division of Genetics (G.F.C.), Children's Hospital, Boston; the Department of Pediatrics, Harvard Medical School, Boston (S.E.L., G.F.C., S.D.C.); New England Research Institutes, Watertown, Mass. (L.A.S., A.M.L.); the Department of Pediatric (Cardiology), Molecular and Human Genetics, and Cardiovascular Sciences, Texas Children's Hospital and Baylor College of Medicine, Houston (J.A.T.); the Department of Medicine, Brigham and Women's Hospital, Boston (E.J.O.); Genzyme Corporation, Cambridge, Mass. (G.F.C.); and the Department of Pediatrics, Albany Medical College, Albany, N.Y. (P.R.L.).

Address reprint requests to Dr. Lipshultz at the Division of Pediatric Cardiology, University of Rochester Medical Center, 601 Elmwood Ave., Box 631, Rochester, NY 14642, or at steve_lipshultz{at}urmc.rochester.edu.

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