A predictive model for left ventricular reverse remodeling after pharmacological therapy in children with recent-onset dilated cardiomyopathy

This retrospective study analyzed data from 146 pediatric patients with dilated cardiomyopathy (DCM) who were hospitalized between January 2012 and June 2023. The cohort had a median age of 6.0 years (IQR: 1.0-12.0) and comprised 61.6% males. During a median follow-up period of 30 months (IQR: 15-50), 55 patients (37.7%) achieved left ventricular reverse remodeling (LVRR), while 58 patients (39.7%) died, and 33 patients (22.6%) showed persistent cardiac dysfunction. The study identified three independent predictors of LVRR: younger age at diagnosis, lower baseline left ventricular end-diastolic dimension (LVEDD) Z-score, and shorter QRS interval. The predictive model demonstrated excellent discrimination with a C-index of 0.903 (95% CI: 0.857-0.950) and maintained strong performance after internal validation (adjusted C-index: 0.895), achieving 90.3% sensitivity and 89.5% specificity for predicting LVRR in pediatric DCM patients.