ECHOCARDIOGRAPHY OF DILATED CARDIOMYOPATHY IN CHILDREN

Echocardiography is useful and reliable in the diagnosis and management of children with dilated cardiomyopathy. M-mode echocardiogrphy provides quantitative information of left ventricular and left atrial dimensions and left ventricular wall thickness. Left ventricular function including shortening fraction, mean velocity of circumferential fiber shortening (V(cf), systolic time intervals, left ventricular wall thickening and thinning rate, isovolumic contraction time, and wall stress can be derived from M-mode study. Left ventricular and left atrial dimensions are usually 1.5 times normal. Left ventricular systolic function is markedly reduced. Shortening fraction can be easily obtained and is the most informative index for assessing the severity of illness. Very low shortening fraction at presentation and follow-up (12-15%) is a poor progonostic sign. Two-dimensional echocardiography is valuable for excluding valvular lesion or coronary artery anomaly and detection of intracardiac thrombus. The left ventricular free wall is usually more severely affected than the ventricular septum as seen by two-dimensional echocardiography.