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Clinical features and outcomes of fulminant myocarditis revealed by a nationwide cohort study
Myocarditis is an inflammatory disease of the myocardium often caused by viral infections or autoimmune diseases. Fulminant myocarditis (FM) is a rare and severe myocarditis characterized by hemodynamically unstable conditions requiring inotropes and/or mechanical circulatory support. The natural history of FM and its clinical features are incompletely understood due to a lack of generalizable evidence. A team of researchers from Nara Medical University and the National Cerebral and Cardiovascular Center conducted a nationwide cohort study of patients with histologically proven FM in 235 cardiovascular hospitals across Japan. They revealed that the 90-day mortality was 29%, and some specific clinical findings such as...
Clinical features and outcomes of fulminant myocarditis revealed by a nationwide cohort study
Myocarditis is an inflammatory disease of the myocardium often caused by viral infections or autoimmune diseases. Fulminant myocarditis (FM) is a rare and severe myocarditis characterized by hemodynamically unstable conditions requiring inotropes and/or mechanical circulatory support. The natural history of FM and its clinical features are incompletely understood due to a lack of generalizable evidence.
A team of researchers from Nara Medical University and the National Cerebral and Cardiovascular Center conducted a nationwide cohort study of patients with histologically proven FM in 235 cardiovascular hospitals across Japan. They revealed that the 90-day mortality was 29%, and some specific clinical findings such as older age, non-sinus rhythm at admission, left ventricular ejection fraction <40%, and ventricular arrhythmia on the first day and severe histological damage to the myocardium were all associated with a worse prognosis.
"A comprehensive assessment of both clinical and pathological findings may be helpful in predicting outcome in patients with FM. Our results showed that approximately half of patients with clinically diagnosed FM did not undergo endomyocardial biopsy, and increased performance of biopsies could improve the management of FM." – Dr. Koshiro Kanaoka.
The next steps for this research are to clarify the effective treatment and immunological mechanism of inflammation in patients with FM.
The research was published in Circulation, the official journal of the American Heart Association, as “Features and Outcomes of Histologically Proven Myocarditis with Fulminant Presentation” (DOI: 10.1161/CIRCULATIONAHA.121.058869).
This research was supported by the Japan Agency for Medical Research and Development Grant 21ek0109528 and the Japan Society for the Promotion of Science KAKENHI Grant 20K08453.
Source:
National Cerebral and Cardiovascular Center
Reference:
Kanaoka, K., et al. (2022) Features and results of histologically proven myocarditis with fulminant presentation. Traffic. doi.org/10.1161/CIRCULATIONAHA.121.058869.
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