Could the unfortunate outcome of pediatric acute myocarditis be predicted? Factors contributing to a poor outcome in myocarditis
Copyright © 2021 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved..
OBJECTIVE: Myocarditis has spontaneous resolution in 50% of patients. Our study aimed to define risk factors for developing dilated cardiomyopathy (DCM) and death in pediatric patients with acute myocarditis (AM).
METHODS: The retrospective cohort study included all patients with treated AM. The Mother and Child Health Institute from January 2011 to March 2019.
RESULTS: In the study, 62 patients were included, 40 boys and 22 girls (11.15±5.86 years) with AM. Twelve out of sixty-two children had acute fulminant myocarditis. Four patients died in the acute phase of AM, and 11 developed DCM. Follow up was 27.14±36.52 months. Patients with poor outcome (DCM development) were under the age of seven (odds ratio [OR] 10.1; p=0.003), more likely to be girls (OR 4.6; p=0.03), and had fulminant myocarditis (OR 27.0; <0.001). An ejection fraction (EF) <55% and fractional shortening (FS) <30% increased risk of DCM 13- and 5-fold, respectively, but patients with EF between 40 and 55% remain at highest risk of developing DCM. There was a 12-fold increased risk for DCM in patients with left ventricular end-diastolic diameter Z score >2+. The receiver operator curve showed that the lactate dehydrogenase (LDH) cut-off value for developing DCM was 1780 mmol/l (sensitivity 80%, specificity 100%).
CONCLUSION: Acute fulminant myocarditis was an independent risk factor for DCM. Children with EF between 40 and 50% at admission were at highest risk of developing DCM. Lactate dehydrogenase value could be a significant prognostic value for the outcome of pediatric myocarditis.
| Errataetall: |
CommentIn: Rev Port Cardiol (Engl Ed). 2021 Sep;40(9):639-640. - PMID 34503700 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - 40(2021), 9 vom: 30. Sept., Seite 631-638 Zur Gesamtaufnahme - volume:40 |
|---|
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Krasic, Stasa [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Death |
|---|
| Anmerkungen: |
Date Completed 04.10.2021 Date Revised 04.10.2021 published: Print CommentIn: Rev Port Cardiol (Engl Ed). 2021 Sep;40(9):639-640. - PMID 34503700 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.repce.2020.10.020 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM330459503 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM330459503 | ||
| 003 | DE-627 | ||
| 005 | 20231225211329.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.repce.2020.10.020 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1101.xml |
| 035 | |a (DE-627)NLM330459503 | ||
| 035 | |a (NLM)34503699 | ||
| 035 | |a (PII)S2174-2049(21)00252-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Krasic, Stasa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Could the unfortunate outcome of pediatric acute myocarditis be predicted? Factors contributing to a poor outcome in myocarditis |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.10.2021 | ||
| 500 | |a Date Revised 04.10.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Rev Port Cardiol (Engl Ed). 2021 Sep;40(9):639-640. - PMID 34503700 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVE: Myocarditis has spontaneous resolution in 50% of patients. Our study aimed to define risk factors for developing dilated cardiomyopathy (DCM) and death in pediatric patients with acute myocarditis (AM) | ||
| 520 | |a METHODS: The retrospective cohort study included all patients with treated AM. The Mother and Child Health Institute from January 2011 to March 2019 | ||
| 520 | |a RESULTS: In the study, 62 patients were included, 40 boys and 22 girls (11.15±5.86 years) with AM. Twelve out of sixty-two children had acute fulminant myocarditis. Four patients died in the acute phase of AM, and 11 developed DCM. Follow up was 27.14±36.52 months. Patients with poor outcome (DCM development) were under the age of seven (odds ratio [OR] 10.1; p=0.003), more likely to be girls (OR 4.6; p=0.03), and had fulminant myocarditis (OR 27.0; <0.001). An ejection fraction (EF) <55% and fractional shortening (FS) <30% increased risk of DCM 13- and 5-fold, respectively, but patients with EF between 40 and 55% remain at highest risk of developing DCM. There was a 12-fold increased risk for DCM in patients with left ventricular end-diastolic diameter Z score >2+. The receiver operator curve showed that the lactate dehydrogenase (LDH) cut-off value for developing DCM was 1780 mmol/l (sensitivity 80%, specificity 100%) | ||
| 520 | |a CONCLUSION: Acute fulminant myocarditis was an independent risk factor for DCM. Children with EF between 40 and 50% at admission were at highest risk of developing DCM. Lactate dehydrogenase value could be a significant prognostic value for the outcome of pediatric myocarditis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Death | |
| 650 | 4 | |a Dilated cardiomyopathy | |
| 650 | 4 | |a Miocardiopatia dilatada | |
| 650 | 4 | |a Miocardite | |
| 650 | 4 | |a Morte | |
| 650 | 4 | |a Myocarditis | |
| 650 | 4 | |a Outcomes | |
| 650 | 4 | |a Pediatria | |
| 650 | 4 | |a Pediatric | |
| 650 | 4 | |a Prognótico | |
| 700 | 1 | |a Prijic, Sergej |e verfasserin |4 aut | |
| 700 | 1 | |a Ninic, Sanja |e verfasserin |4 aut | |
| 700 | 1 | |a Nesic, Dejan |e verfasserin |4 aut | |
| 700 | 1 | |a Bjelakovic, Bojko |e verfasserin |4 aut | |
| 700 | 1 | |a Petrovic, Gordana |e verfasserin |4 aut | |
| 700 | 1 | |a Cerovic, Ivana |e verfasserin |4 aut | |
| 700 | 1 | |a Vukomanovic, Vladislav |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |g 40(2021), 9 vom: 30. Sept., Seite 631-638 |
| 773 | 1 | 8 | |g volume:40 |g year:2021 |g number:9 |g day:30 |g month:09 |g pages:631-638 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.repce.2020.10.020 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 40 |j 2021 |e 9 |b 30 |c 09 |h 631-638 | ||