4.8 Article

The incidence of pediatric cardiomyopathy in two regions of the United States

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 348, Issue 17, Pages 1647-1655

Publisher

MASSACHUSETTS MEDICAL SOC/NEJM
DOI: 10.1056/NEJMoa021715

Keywords

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Funding

  1. NCI NIH HHS [CA55576, CA68484, CA79060] Funding Source: Medline
  2. NHLBI NIH HHS [HL53392] Funding Source: Medline

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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.

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