Aggiornamento
Le urgenze cardiologiche in età perinatale Parte II
ARRHYTHMIAS AND CARDIOMYOPATHIES IN NEWBORN AND CHILDREN
UGO VAIRO1, PETRONILLA APPIO1, ROCCO LEONE1, MARIA VITTORIA SCHIAVO2, DONATELLO SALVATORE2, MARIA PIA MIRAUDA2, ROSARIA ABATE2, CAROLINA IANNIELLO3, SEBASTIANO DE VICO3, ANTONIO SMALDORE3, GIORGIO MADONNA3, GIANBATTISTA GALLICCHIO3, SAVERIO DE MARCA3, GIUSEPPE ADURNO4, MARIA ROSARIA TAGLIENTE5, SAVINO MASTROPASQUA6, GABRIELE D’AMATO6, FABIO FORTE7, EMMA CANOSA7, NICOLA D’ANDREA7
1Cardiologia Pediatrica
2Pediatria
3Terapia Intensiva Neonatale
4Terapia Intensiva Cardiopediatrica, Azienda Ospedaliera “San Carlo”, Potenza
5Cardiologia Pediatrica,
6Terapia Intensiva Neonatale Azienda Ospedaliera “Di Venere - Giovanni XXIII”, Bari
7Pediatria, Ospedale “Madonna delle Grazie”, Matera
Maggio 2004 - pagg. 293 -300
Abstract
Continued postnatal development of the conduction system and of the sympathetic nervous system
of the heart may predispose the newborn to arrhythmias and conduction disturbances
that are not seen in older children. In addition, unfavorable environmental factors, such as a
maternal disease state, pharmacologic agents given to the mother or neonate, and postnatal
difficulties of the newborn (hypoxia, acidosis, hypothermia, metabolic disturbances, electrolyte
imbalance) all can contribute to the rhythm disturbance. The different types of disrrhythmias
are analized, particularly the supraventricular tachycardia (SVT)(1:10.000 in
newborn) and complete atrioventricular block (AV block) (1:20.000). In SVT, if the patient is
unresponsive to vagal stimulatory maneuvers , to adenosine and is in congestive heart failure,
cardioversion may be performed. Congenital complete heart block can be associated with
congenital heart diseases. Maternal lupus erythematosus or other connettive tissue disease has
a frequent association with congenital AV block.
The three types of cardiomyopathies (hypertrophic, dilated and restrictive) are functionally different
from one another, and the demands of therapy are also different.
The myocarditis may be caused by an infectious agent or immune mediated process. A diagnostic
and therapeutic protocol for management of the myocarditis in children is reported.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Gillette PC, Garson A. Pediatric Cardiac Dysrhythmias.
Grune & Stratton, 1981.
2. Marsico F, Musto B, Greco R. Le aritmie dell’età pediatrica. G Ital Cardiol 1976;4:732
3. Calabrò R, Caso P, Vairo U, Vosa C, Musto B, Marsico L, Violini R, de Leva F. Le urgenze in cardiologia pediatrica. Da G. Caturelli (ed).“Cardiological Intensive Care”. Milano: Librex 1988:313-22.
4. Marsico F, Musto B, Cinque C, D’Onofrio A, Paladini R. Terapia delle aritmie ipercinetiche in età pediatrica. In: Attualità in cardiologia pediatrica. Milano: Libreria scientifica Ghedini, 1984:25.
5. Visconti di Massimo U. Le aritmie nell’infanzia. Problemi diagnostici e di terapia. Attualità in cardiologia pediatrica. Milano: ANCE, 1983:31-47.
6. Marsico F, Musto B, D’Onofrio A, Cavallaro C, Musto A. Risultati del trattamento a lungo termine della tachicardia parossistica sopraventricolare nei soggetti in età pediatrica. 20° Corso di aggiornamento cardiologico. Milano 1986:250-2.
7. Ko JK, Deal BJ, Strasburger JF, Benson DW Jr. Supraventricular tachycardia mechanism and their age distribution in pediatric patients. Am J Cardiol 1992;69:1028-32.
8. Greco R, Musto B, Arienzo V. Treatment of paroxysmal supraventricular tachycardia in infancy with digitalis, adenosine 5 triphosphate and verapamil, a comparative study. Circulation 1982;66:504-8.
9. Musto B, D’Onofrio A, Cavallaro C, Musto A. Electrophysiological effects and clinical efficacy of propafenone in children with recurrent paroxysmal supraventricular tachycardia. Circulation 1988;78:863-9.
10. Musto B, D’Onofrio A, Cavallaro C, Musto A, Greco R. Electrophysiologic effects and clinical efficacy of flecainide in children with recurrent paroxysmal supraventricular tachycardia. Am J Cardiol 1988;62:229-33.
11. Ludomirsky A, Garson A Jr. Supraventricular tachycardia. In: Gillette PC, Garson A Jr (eds). Pediatric arrhythmias electrophysiology and pacing. New York: WB Saunders Co, 1990;380-426.
12. Vignati G, Mauri L. Evoluzione e prognosi a medio e lungo termine delle tachicardie sopraventricolari da rientro nel bambino. G Ital Cardiol 1988;18:109-14.
13. Vignati G, Danzi GB, Austoni P, et al. La terapia amiodaronica in età pediatrica: efficacia ed effetti collaterali. G Ital Cardiol 1985; 15:786.
14. Guccione P, Paul T, Garson A. Long-term follow-up of amiodarone therapy in the young: continued efficacy, uninpaired growth, moderate side effects. J Am Coll Cardiol 1990; 15:1118-24.
15. Ventriglia F, Bosco G, Perri C, Mileto F, Belardi C, Mundo L, Critelli G, Colloridi V. Efficacia del sotalolo nelle tachiaritmie sopraventricolari in età pediatrica. Ital J Pediatr 2001;27:898-906.
16. Vignati G. Trattamento delle urgenze aritmiche dell’età pediatrica. Collana “Manuali di Aritmologia”. Bollate (MI): Signum Edizioni 1993.
17. Kugler JD, Danford DA, Deal BJ, et al. Radiofrequency catheter ablation for tachyarrhytmias in children and adolescents. N Engl J Med 1994;330:1481-7.
18. Vignati G, Mauri L, Austoni P, Figini A. Aritmie sopraventricolari nella prima infanzia. Atti del 27° Convegno Internazionale del Centro A. De Gasperis. Milano: Librex 1993;461-7.
19. Zoldivar N, Gelband H, Tamer D. Atrial fibrillation in infancy. J Pediat 1973;83:821-2.
20. Belhassen B, Pauzner D, Blieden L. Intrauterine and postnatal atrial fibrillation in the Wolff-Parkinson-White syndrome. Circulation 1982;66:1124-8.
21. Leenhardt A, Lucet V, Denjoy I, et al. Catecholaminergic polymorphic ventricular tachycardia in children. Circulation 1995;91:1512-9.
22. Drago F, Vignati G, Calzolari A, et al. Studio clinico-prognostico delle tachicardie ventricolari adrenergiche a cuore sano in età pediatrica. G Ital Cardiol 1994;24(2):C38.
23. Romano C, Gemme C, Pongiglione R. Aritmie cardiache rare dell’età pediatrica. La Clinica Pediatrica 1963;45:656-83. 24) Jervell A, Lange-Nielsen F. Congenital deaf-mutism, functional heart disease with prolongation of the QT interval, and sudden death. Am Heart J 1957;54:59-68.
25. Schwartz PJ, Locati E. The idiopatic long QT syndrome. Pathogenetic mechanism and therapy. Eur Heart J 1985;6(Suppl D):103-14.
26. Micharlsson M, Engle MA. Congenital complete heart block: an international study of the natural history. Cardiovas Clin 1972;4:85- 101.
27. Park MK. Disturbances of atrioventricular conduction. In: Pediatric cardiology for practitioners. 3° Edition. Mosby, 1996;cap 25:350- 352.
28. Taylor PV, Scott JS, Gerlis L, et al. Maternal antibodies agonist fetal cardiac antigens in congenital heart block. N Engl J Med 1986;35:667-72.
29. Park MK. Pacemakers in children. In: Pediatric cardiology for practitioners. 3° Edition. Mosby 1996; cap 26:353-7.
30. Vignati G, Mauri L, Lunati M, et al. Complicanze e sequele dell’elettrostimolazione cardiaca in età pediatrica. G Ital Cardiol 1992; 22:415-23.
31. Karpawich PP, Gillette PC, Garson A Jr. Congenital complete atrioventricular block:clinical and electrophysiologic predictors of need for pacemaker insertion. Am J Cardiol 1981;48:1098-102.
32. Pinsky WW, Gillette PC, Garson A Jr. Diagnosis, management and long-term results of patients with congenital complete atrioventricular block. Pediatrics 1982;69:728-33.
33. Michaelsson M, Jonzon A, Riesenfeld T. Isolated congenital complete atrioventricular block in adult life: a prospective study. Circulation 1995;91:442-9.
34. Friedman RA. Congenital AV block. Circulation 1995;92:283-5.
35. Simpson J, Rosenthal E. Arrhythmias: fetal arrhytmias; fetal heart block. In: Allan L, et al. Textbook of fetal cardiology. Greenwich Medical Media, 2000;cap 18:421-51.
36. Azancot-Benisty A, Jacqz-Aigrain E, Guirgis NM, Decrepy A, Oury JF. Blot P. Clinical and Pharmacologic study of fetal supraventricular tachy-arrhytmias. J Pediatr 1992;121: 608-13.
37. Silverman NH, Enderlein MA, Stanger P, et al. Recognition of fetal arrhythmias by echocardiography. J Clin Ultrasound 1985;13:255- 63
38. Brook MM, Silverman NH, Villegas M. Cardiac ultrasonography in structural abnormalities and arrhythmias. West J Med 1993;159:286-300.
39. Simpson JM, Sharland GH. Fetal Tachycardias: management and outcome of 127 consecutive cases. Heart 1998;79:576-81.
40. Kohl T, Tercanli S, Kececioglu D, Holzgreve W. Direct fetal administration of adenosine for the termination of incessant supraventricular tachycardia. Obstet Gynecol 1995; 85:873-4.
41. Hansmann M, Gembruch U, Bald R, et al. Fetal tachyarrhythmias: transplacental and direct treatment of the fetus-a report of sixty cases. Ultrasound Ostet Gynecol 1991;1:162-70.
42. Ito S, Magee L, Smallhorn J. Drug therapy for fetal arrhythmias. Clin Perinatol 1994; 21:543-72.
43. Flack NJ, Zosmer N, Bennett PR, et al. Amiodarone given by three routes to terminate fetal atrial flutter associated with severe hydrops. Obstet Gynecol 1993;82:714-6.
44. Malcic I, Jelusic M, Knievald H, et al. Epidemiology of cardiomyopathies in children and adolescents: a retrospective study over the last 10 years. Cardiol Young 2002;12:253-9.
45. Report of the 1995 World Health Organization/ International Society and Federation of Cardiology. Task Force on the Definition and Classification of Cardiomyopaties. Circulation 1996;93:841-2.
46. Azeka E, Bocchi E, Ramires JA, Ebaid M. Preliminary study of evaluation of ventricular function after using carvedilol in children with severe dilated cardiomyopathy. 3rd World Congress of Pediatric Cardiology & Cardiac Surgery. Cardiol Young 2001;11(Supp 1-May): 15.
47. Laer S, Mir TS, Behn F, et al. Carvedilol therapy in pediatric patients with congestive heart failure: a study investigating clinical and pharmacokinetic parameters. Am Heart J 2002;143:916-22.
48. Shah NJ, Gachara N, Prabhakan S, et al. Efficacy of carvedilol in management of congestive heart failure in infants with dilated cardiomyopathy. 3rd World Congress of Pediatric Cardiology & Cardiac Surgery. Cardiol Young 2001;11(Supp 1-May):31.
49. Taliercio CP, Seward JB, Driscoll DJ. Idiopathic dilated cardiomyopathy in the young: clinical profile and natural history. J Am Coll Cardiol 1985;6:1126-32.
50. Zuberbuhler JR, Fricker FJ, Griffith BP. Trapianto cardiaco nei bambini. In: Cardiology clinics (Edizione italiana) Milano, Mc- Graw-Hill Libri Italia 1990:223-31.
51. Caforio ALP. Le miocarditi. G Ital Cardiol 1999;29:1169-70.
52. Lee KJ, McCrindle BW, Bohn DJ, et al. Clinical outcomes of acute myocarditis in childhood. Hear 1999;82:226-33.
53. Drucher NA, Colan SD, Lewis AB. Gamma- globulin treatment of acute myocarditis in the pediatric population. Circulation 1994; 89:252-7.
54. Schmalz AA, Trowitzsch E, Vogt J, et al. Multicenter treatment trial for chronic myocarditis in childhood: problems and preliminary results. 3rd World Congress of Pediatric Cardiology and Cardiac Surgery. Cardiol Young 2001;1 (Supp 1-May):17.
55. Gagliardi MG, Bevilacqua M, Squitieri C. et al. Dilated cardiomyopathy caused by acute myocarditis in pediatric patients: evolution of myocardial damage in a group of potential heart transplant candidates. J Heart Lung Transplant 1993;12:224-9.
56. Sinagra G, Di Lenarda A, Pinamonti B, et al. La classificazione delle cardiomiopatie. G Ital Cardiol 1999;29:1165-8.
57. Cecchi F, Olivotto I. Terapia della cardiomiopatia ipertrofica. G Ital Cardiol 1999;29: 1199-203.
58. Bruno E, Maisuls H, Juaneda E, Moreyra E, Alday LE. Clinical features of hypertrophic cardiomyopathy in the young. Cardiol Young 2002;12:147-52.
59. Pacileo G, De Cristoforo M, Russo MG, et al. Hypertrophic cardiomyopathy in pediatric patients: effect of verapamil on regional and global left ventricular diastolic function. Can J Cardiol 2000;16(2):146-52.
60. Nield LE, McCrindle BW, Bohn DJ, et al. Outcomes for children with cardiomyopathy awaiting transplantation. Cardiol Young 2000; 10:358-66.
61. Lewis AB. Clinical profile and outcome of restrictive cardiomyopathy in children. Am Heart J 1992;123(6)1589-93.
62. Yshizato T, Edwards WD, Alboliras ET, et al. Safety and utility of endomyocardial biopsy in infants, children and adolescents: a review of 66 procedures in 53 patients. J Am Coll Cardiol 1990;15:436-42.
2. Marsico F, Musto B, Greco R. Le aritmie dell’età pediatrica. G Ital Cardiol 1976;4:732
3. Calabrò R, Caso P, Vairo U, Vosa C, Musto B, Marsico L, Violini R, de Leva F. Le urgenze in cardiologia pediatrica. Da G. Caturelli (ed).“Cardiological Intensive Care”. Milano: Librex 1988:313-22.
4. Marsico F, Musto B, Cinque C, D’Onofrio A, Paladini R. Terapia delle aritmie ipercinetiche in età pediatrica. In: Attualità in cardiologia pediatrica. Milano: Libreria scientifica Ghedini, 1984:25.
5. Visconti di Massimo U. Le aritmie nell’infanzia. Problemi diagnostici e di terapia. Attualità in cardiologia pediatrica. Milano: ANCE, 1983:31-47.
6. Marsico F, Musto B, D’Onofrio A, Cavallaro C, Musto A. Risultati del trattamento a lungo termine della tachicardia parossistica sopraventricolare nei soggetti in età pediatrica. 20° Corso di aggiornamento cardiologico. Milano 1986:250-2.
7. Ko JK, Deal BJ, Strasburger JF, Benson DW Jr. Supraventricular tachycardia mechanism and their age distribution in pediatric patients. Am J Cardiol 1992;69:1028-32.
8. Greco R, Musto B, Arienzo V. Treatment of paroxysmal supraventricular tachycardia in infancy with digitalis, adenosine 5 triphosphate and verapamil, a comparative study. Circulation 1982;66:504-8.
9. Musto B, D’Onofrio A, Cavallaro C, Musto A. Electrophysiological effects and clinical efficacy of propafenone in children with recurrent paroxysmal supraventricular tachycardia. Circulation 1988;78:863-9.
10. Musto B, D’Onofrio A, Cavallaro C, Musto A, Greco R. Electrophysiologic effects and clinical efficacy of flecainide in children with recurrent paroxysmal supraventricular tachycardia. Am J Cardiol 1988;62:229-33.
11. Ludomirsky A, Garson A Jr. Supraventricular tachycardia. In: Gillette PC, Garson A Jr (eds). Pediatric arrhythmias electrophysiology and pacing. New York: WB Saunders Co, 1990;380-426.
12. Vignati G, Mauri L. Evoluzione e prognosi a medio e lungo termine delle tachicardie sopraventricolari da rientro nel bambino. G Ital Cardiol 1988;18:109-14.
13. Vignati G, Danzi GB, Austoni P, et al. La terapia amiodaronica in età pediatrica: efficacia ed effetti collaterali. G Ital Cardiol 1985; 15:786.
14. Guccione P, Paul T, Garson A. Long-term follow-up of amiodarone therapy in the young: continued efficacy, uninpaired growth, moderate side effects. J Am Coll Cardiol 1990; 15:1118-24.
15. Ventriglia F, Bosco G, Perri C, Mileto F, Belardi C, Mundo L, Critelli G, Colloridi V. Efficacia del sotalolo nelle tachiaritmie sopraventricolari in età pediatrica. Ital J Pediatr 2001;27:898-906.
16. Vignati G. Trattamento delle urgenze aritmiche dell’età pediatrica. Collana “Manuali di Aritmologia”. Bollate (MI): Signum Edizioni 1993.
17. Kugler JD, Danford DA, Deal BJ, et al. Radiofrequency catheter ablation for tachyarrhytmias in children and adolescents. N Engl J Med 1994;330:1481-7.
18. Vignati G, Mauri L, Austoni P, Figini A. Aritmie sopraventricolari nella prima infanzia. Atti del 27° Convegno Internazionale del Centro A. De Gasperis. Milano: Librex 1993;461-7.
19. Zoldivar N, Gelband H, Tamer D. Atrial fibrillation in infancy. J Pediat 1973;83:821-2.
20. Belhassen B, Pauzner D, Blieden L. Intrauterine and postnatal atrial fibrillation in the Wolff-Parkinson-White syndrome. Circulation 1982;66:1124-8.
21. Leenhardt A, Lucet V, Denjoy I, et al. Catecholaminergic polymorphic ventricular tachycardia in children. Circulation 1995;91:1512-9.
22. Drago F, Vignati G, Calzolari A, et al. Studio clinico-prognostico delle tachicardie ventricolari adrenergiche a cuore sano in età pediatrica. G Ital Cardiol 1994;24(2):C38.
23. Romano C, Gemme C, Pongiglione R. Aritmie cardiache rare dell’età pediatrica. La Clinica Pediatrica 1963;45:656-83. 24) Jervell A, Lange-Nielsen F. Congenital deaf-mutism, functional heart disease with prolongation of the QT interval, and sudden death. Am Heart J 1957;54:59-68.
25. Schwartz PJ, Locati E. The idiopatic long QT syndrome. Pathogenetic mechanism and therapy. Eur Heart J 1985;6(Suppl D):103-14.
26. Micharlsson M, Engle MA. Congenital complete heart block: an international study of the natural history. Cardiovas Clin 1972;4:85- 101.
27. Park MK. Disturbances of atrioventricular conduction. In: Pediatric cardiology for practitioners. 3° Edition. Mosby, 1996;cap 25:350- 352.
28. Taylor PV, Scott JS, Gerlis L, et al. Maternal antibodies agonist fetal cardiac antigens in congenital heart block. N Engl J Med 1986;35:667-72.
29. Park MK. Pacemakers in children. In: Pediatric cardiology for practitioners. 3° Edition. Mosby 1996; cap 26:353-7.
30. Vignati G, Mauri L, Lunati M, et al. Complicanze e sequele dell’elettrostimolazione cardiaca in età pediatrica. G Ital Cardiol 1992; 22:415-23.
31. Karpawich PP, Gillette PC, Garson A Jr. Congenital complete atrioventricular block:clinical and electrophysiologic predictors of need for pacemaker insertion. Am J Cardiol 1981;48:1098-102.
32. Pinsky WW, Gillette PC, Garson A Jr. Diagnosis, management and long-term results of patients with congenital complete atrioventricular block. Pediatrics 1982;69:728-33.
33. Michaelsson M, Jonzon A, Riesenfeld T. Isolated congenital complete atrioventricular block in adult life: a prospective study. Circulation 1995;91:442-9.
34. Friedman RA. Congenital AV block. Circulation 1995;92:283-5.
35. Simpson J, Rosenthal E. Arrhythmias: fetal arrhytmias; fetal heart block. In: Allan L, et al. Textbook of fetal cardiology. Greenwich Medical Media, 2000;cap 18:421-51.
36. Azancot-Benisty A, Jacqz-Aigrain E, Guirgis NM, Decrepy A, Oury JF. Blot P. Clinical and Pharmacologic study of fetal supraventricular tachy-arrhytmias. J Pediatr 1992;121: 608-13.
37. Silverman NH, Enderlein MA, Stanger P, et al. Recognition of fetal arrhythmias by echocardiography. J Clin Ultrasound 1985;13:255- 63
38. Brook MM, Silverman NH, Villegas M. Cardiac ultrasonography in structural abnormalities and arrhythmias. West J Med 1993;159:286-300.
39. Simpson JM, Sharland GH. Fetal Tachycardias: management and outcome of 127 consecutive cases. Heart 1998;79:576-81.
40. Kohl T, Tercanli S, Kececioglu D, Holzgreve W. Direct fetal administration of adenosine for the termination of incessant supraventricular tachycardia. Obstet Gynecol 1995; 85:873-4.
41. Hansmann M, Gembruch U, Bald R, et al. Fetal tachyarrhythmias: transplacental and direct treatment of the fetus-a report of sixty cases. Ultrasound Ostet Gynecol 1991;1:162-70.
42. Ito S, Magee L, Smallhorn J. Drug therapy for fetal arrhythmias. Clin Perinatol 1994; 21:543-72.
43. Flack NJ, Zosmer N, Bennett PR, et al. Amiodarone given by three routes to terminate fetal atrial flutter associated with severe hydrops. Obstet Gynecol 1993;82:714-6.
44. Malcic I, Jelusic M, Knievald H, et al. Epidemiology of cardiomyopathies in children and adolescents: a retrospective study over the last 10 years. Cardiol Young 2002;12:253-9.
45. Report of the 1995 World Health Organization/ International Society and Federation of Cardiology. Task Force on the Definition and Classification of Cardiomyopaties. Circulation 1996;93:841-2.
46. Azeka E, Bocchi E, Ramires JA, Ebaid M. Preliminary study of evaluation of ventricular function after using carvedilol in children with severe dilated cardiomyopathy. 3rd World Congress of Pediatric Cardiology & Cardiac Surgery. Cardiol Young 2001;11(Supp 1-May): 15.
47. Laer S, Mir TS, Behn F, et al. Carvedilol therapy in pediatric patients with congestive heart failure: a study investigating clinical and pharmacokinetic parameters. Am Heart J 2002;143:916-22.
48. Shah NJ, Gachara N, Prabhakan S, et al. Efficacy of carvedilol in management of congestive heart failure in infants with dilated cardiomyopathy. 3rd World Congress of Pediatric Cardiology & Cardiac Surgery. Cardiol Young 2001;11(Supp 1-May):31.
49. Taliercio CP, Seward JB, Driscoll DJ. Idiopathic dilated cardiomyopathy in the young: clinical profile and natural history. J Am Coll Cardiol 1985;6:1126-32.
50. Zuberbuhler JR, Fricker FJ, Griffith BP. Trapianto cardiaco nei bambini. In: Cardiology clinics (Edizione italiana) Milano, Mc- Graw-Hill Libri Italia 1990:223-31.
51. Caforio ALP. Le miocarditi. G Ital Cardiol 1999;29:1169-70.
52. Lee KJ, McCrindle BW, Bohn DJ, et al. Clinical outcomes of acute myocarditis in childhood. Hear 1999;82:226-33.
53. Drucher NA, Colan SD, Lewis AB. Gamma- globulin treatment of acute myocarditis in the pediatric population. Circulation 1994; 89:252-7.
54. Schmalz AA, Trowitzsch E, Vogt J, et al. Multicenter treatment trial for chronic myocarditis in childhood: problems and preliminary results. 3rd World Congress of Pediatric Cardiology and Cardiac Surgery. Cardiol Young 2001;1 (Supp 1-May):17.
55. Gagliardi MG, Bevilacqua M, Squitieri C. et al. Dilated cardiomyopathy caused by acute myocarditis in pediatric patients: evolution of myocardial damage in a group of potential heart transplant candidates. J Heart Lung Transplant 1993;12:224-9.
56. Sinagra G, Di Lenarda A, Pinamonti B, et al. La classificazione delle cardiomiopatie. G Ital Cardiol 1999;29:1165-8.
57. Cecchi F, Olivotto I. Terapia della cardiomiopatia ipertrofica. G Ital Cardiol 1999;29: 1199-203.
58. Bruno E, Maisuls H, Juaneda E, Moreyra E, Alday LE. Clinical features of hypertrophic cardiomyopathy in the young. Cardiol Young 2002;12:147-52.
59. Pacileo G, De Cristoforo M, Russo MG, et al. Hypertrophic cardiomyopathy in pediatric patients: effect of verapamil on regional and global left ventricular diastolic function. Can J Cardiol 2000;16(2):146-52.
60. Nield LE, McCrindle BW, Bohn DJ, et al. Outcomes for children with cardiomyopathy awaiting transplantation. Cardiol Young 2000; 10:358-66.
61. Lewis AB. Clinical profile and outcome of restrictive cardiomyopathy in children. Am Heart J 1992;123(6)1589-93.
62. Yshizato T, Edwards WD, Alboliras ET, et al. Safety and utility of endomyocardial biopsy in infants, children and adolescents: a review of 66 procedures in 53 patients. J Am Coll Cardiol 1990;15:436-42.