توانبخشی قلب در کاردیومیوپاتی کودکان Cardiac rehabilitation in pediatric cardiomyopathy

Introduction Pediatric cardiomyopathies are rare diseases affecting 1.1-1.5 per 100,000 children, 1, 2 and can be categorized as dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), restrictive cardiomyopathy (RCM), arrhythmogenic right ventricular cardiomyopathy (AVRC), and left ventricular non-compaction cardiomyopathy (LVNC). While the etiologies of these diseases can range from genetic to toxic exposures, the cause is idiopathic for nearly two-thirds of children with a form of cardiomyopathy.2-4 Current therapies for cardiomyopathies are targeted towards improving cardiac function, preventing or controlling arrhythmias, and minimizing cardiac symptoms, but heart transplantation remains the definitive therapy for progressive disease. Treatment of children with cardiomyopathy has followed adult heart failure trials as there has been only one pediatric heart failure medication trial.5-8 Furthermore, as reported in a review from the Pediatric Cardiomyopathy Registry (PCMR), children with heart failure are frequently undertreated, with only 66% receiving angiotensin converting enzyme inhibitors and even fewer (4%) treated with beta blockers within the first month after diagnosis.9 Nevertheless, recent data from this PCMR suggest that survival has improved in the current era, despite a persistently high rate of heart transplantation which has not decreased in the most recent era.10 The benefits of exercise training are well established for healthy adults. However, there is a paucity of data regarding the benefit and feasibility of exercise training in pediatric cardiomyopathy patients. This work looks to expand upon the discussion of cardiac rehabilitation and exercise training in pediatric cardiomyopathy patients at the 4th International Conference on Cardiomyopathy in Children.