Fulminant Myocarditis

Ginsberg, F; Parrillo, Joseph E.

doi:10.1016/j.ccc.2013.03.004

Cited by 96 publications

(90 citation statements)

References 67 publications

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“…For example, we show that advanced HF from myocarditis occurs mostly in young male patients. These age and sex differences are consistent with previous reports, where myocarditis has been shown to affect younger patients [12][13][14] and to be linked to male sex hormones. 6,15 The diagnosis of myocarditis was associated with higher acuity at listing, evidenced by a 10-fold higher requirement for biventricular MCS, 5-fold higher requirement for ECMO, and 3-fold higher requirement for ventilator need.…”

Section: Discussionsupporting

confidence: 92%

“…Accordingly, myocarditis patients were more frequently listed as status 1A with less time for optimization of heart failure therapy and implantable cardioverterdefibrillators placement. Our data confirm that myocarditis affects both ventricles, 14,16 and therefore, patients require uni-and biventricular MCS more frequently, 17 similar to toxic cardiomyopathies, such as chemotherapy-induced cardiomyopathy. 18 We also describe the natural history of myocarditis patients in the transplant waitlist and confirm a higher likelihood of recovery.…”

Section: Discussionsupporting

confidence: 78%

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Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

ElAmm

Al‐Kindi

Oliveira

2016

Circ: Heart Failure

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Background-Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients. Despite higher allosensitization, patients with myocarditis had similar post-transplant rejection, retransplantation, and survival rates compared with other groups. Conclusions-Patients with the diagnosis of myocarditis listed for orthotopic heart transplantation are younger, sicker, and recover more frequently but require more biventricular mechanical circulatory support. Heart transplantation survival is comparable to that of patients with other types of heart failure. (Circ Heart Fail. 2016;9:e003259. Methods and Results-We

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 78%

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

ElAmm

Al‐Kindi

Oliveira

2016

Circ: Heart Failure

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“…21 Patients with severe/worsening HF and low cardiac output syndrome (FM) received intravenous diuretics, oxygen supplementation, and ventilation plus inotropes. 15 Patients with impending or overt cardiogenic shock were treated with MCS. 15,16 An intra-aortic balloon pump alone or in combination with venous-arterial extracorporeal membrane oxygenation (va-ECMO; Levitronix CentriMag centrifugal pump, Levitronix LLC, Waltham, MA) was added in case of persistence of low cardiac output syndrome, generally with the femoral approach.…”

Section: Patient Managementmentioning

confidence: 99%

“…15 Patients with impending or overt cardiogenic shock were treated with MCS. 15,16 An intra-aortic balloon pump alone or in combination with venous-arterial extracorporeal membrane oxygenation (va-ECMO; Levitronix CentriMag centrifugal pump, Levitronix LLC, Waltham, MA) was added in case of persistence of low cardiac output syndrome, generally with the femoral approach. 22 In the pediatric population, central va-ECMO was the first choice.…”

Section: Patient Managementmentioning

confidence: 99%

Survival and Left Ventricular Function Changes in Fulminant Versus Nonfulminant Acute Myocarditis

et al. 2017

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Background: Previous reports have suggested that despite their dramatic presentation, patients with fulminant myocarditis (FM) might have better outcome than those with acute nonfulminant myocarditis (NFM). In this retrospective study, we report outcome and changes in left ventricular ejection fraction (LVEF) in a large cohort of patients with FM compared with patients with NFM. Methods: The study population consists of 187 consecutive patients admitted between May 2001 and November 2016 with a diagnosis of acute myocarditis (onset of symptoms <1 month) of whom 55 required inotropes and/or mechanical circulatory support (FM) and the remaining 132 were hemodynamically stable (NFM). We also performed a subanalysis in 130 adult patients with acute viral myocarditis and viral prodrome within 2 weeks from the onset, which includes 34 with FM and 96 with NFM. Patients with giant-cell myocarditis, eosinophilic myocarditis, or cardiac sarcoidosis and those <15 years of age were excluded from the subanalysis. Results: In the whole population (n=187), the rate of in-hospital death or heart transplantation was 25.5% versus 0% in FM versus NFM, respectively ( P <0.0001). Long-term heart transplantation–free survival at 9 years was lower in FM than NFM (64.5% versus 100%, log-rank P <0.0001). Despite greater improvement in LVEF during hospitalization in FM versus NFM forms (median, 32% [interquartile range, 20%–40%] versus 3% [0%–10%], respectively; P <0.0001), the proportion of patients with LVEF <55% at last follow-up was higher in FM versus NFM (29% versus 9%; relative risk, 3.32; 95% confidence interval, 1.45–7.64, P =0.003). Similar results for survival and changes in LVEF in FM versus NFM were observed in the subgroup (n=130) with viral myocarditis. None of the patients with NFM and LVEF ≥55% at discharge had a significant decrease in LVEF at follow-up. Conclusions: Patients with FM have an increased mortality and need for heart transplantation compared with those with NFM. From a functional viewpoint, patients with FM have a more severely impaired LVEF at admission that, despite steep improvement during hospitalization, remains lower than that in patients with NFM at long-term follow-up. These findings also hold true when only the viral forms are considered and are different from previous studies showing better prognosis in FM.

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“…[1][2][3] The pathogenesis of FM is generally believed 4 to involve infiltration of a large number of inflammatory cells and destruction of myocardial cells in the early stages. Then, allergic reaction or autoimmune involvement can lead to further damage to cardiac muscle cells, resulting in localized or diffuse myocarditis.…”

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confidence: 99%

Changes in serum cardiac myosin light chain 1 levels in children with fulminant myocarditis during continuous blood purification

Sheng

Zhang

Jia

et al. 2017

Rev. Assoc. Med. Bras.

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Sheng C et al. 904 rev assoC med bras 2017; 63(10):904-909 ORIGINAL ARTICLEChanges in serum cardiac myosin light chain 1 levels in children with fulminant myocarditis during continuous blood purification Before and during treatment (48 and 72 hours after treatment, or death), the optical density value of serum CMLC-1 was measured using enzyme-linked immunosorbent assay, and then the serum CMLC-1 concentration was calculated.The correlations between CMLC-1 OD value change and laboratory indexes including creatine kinase-MB (CK-MB), troponin, myohemoglobin and N-terminal pro-brain natriuretic peptide (NT-proBNP) were analyzed. Results:The serum CMLC-1 concentration significantly increased in the children with FM and decreased obviously during CBP therapy. In the same period, the change of CMLC-1 concentration were positively correlated with creatine kinase-MB (r=0.528), troponin (r=0.726), myohemoglobin (r=0.702), and NT-proBNP levels (r=0.589). Conclusion:The serum CMLC-1 concentration increases significantly in children with FM, but CBP therapy can effectively control this increase.

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Fulminant Myocarditis

Cited by 96 publications

References 67 publications

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

Survival and Left Ventricular Function Changes in Fulminant Versus Nonfulminant Acute Myocarditis

Changes in serum cardiac myosin light chain 1 levels in children with fulminant myocarditis during continuous blood purification

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