Exercise Testing in Pediatric Dilated Cardiomyopathy

Abstract

Dilated cardiomyopathy (DCM) is the most common cardiomyopathy in children, and its hallmark is left ventricular (LV) dilation and systolic dysfunction. Impairment of exercise performance in children with DCM is due to a combination of inadequate tissue O2 delivery resulting from impaired heart rate and stroke volume increase with exercise and abnormalities in distribution or impedance to flow in pulmonary and peripheral circulations and of the skeletal muscle. Formal assessment of exercise performance is useful in identifying limitations and eliciting the mechanism of limitations in children with moderate and severe LV dysfunction and has a potential role in risk stratification of those with severe LV dysfunction.