No Obesity Paradox in Pediatric Patients With Dilated Cardiomyopathy

Abstract Objectives This study aimed to examine the role of nutrition in pediatric dilated cardiomyopathy (DCM). Background In adults with DCM, malnutrition is associated with mortality, whereas obesity is associated with survival. Methods The National Heart, Lung, and Blood Institute–funded Pediatric Cardiomyopathy Registry was used to identify patients with DCM and categorized by anthropometric measurements: malnourished (MN) (body mass index [BMI]  95% for age ≥2 years or weight-for-length >95% for  Results Obese patients were older (9.0 vs. 5.7 years for NB; p  z -scores >2, and higher ventricular mass compared with NB. In multivariable analysis, MN was associated with increased risk of death (hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.66 to 3.65; p  Conclusions Malnutrition is associated with increased mortality and other unfavorable echocardiographic and clinical outcomes compared with those of NB. The same effect of obesity on survival was not observed. Further studies are needed investigating the long-term impact of abnormal anthropometric measurements on outcomes in pediatric DCM. (Pediatric Cardiomyopathy Registry; NCT00005391)