Merlo, M;
Ammirati, E;
Gentile, P;
Artico, J;
Cannatà, A;
Finocchiaro, G;
Barbati, G;
Sormani, P;
Varrenti, M;
Perkan, A;
et al.
Merlo, M; Ammirati, E; Gentile, P; Artico, J; Cannatà, A; Finocchiaro, G; Barbati, G; Sormani, P; Varrenti, M; Perkan, A; Fabris, E; Aleksova, A; Bussani, R; Petrella, D; Cipriani, M; Raineri, C; Frigerio, M; Sinagra, G
(2019)
Persistent left ventricular dysfunction after acute lymphocytic myocarditis: Frequency and predictors.
PLoS One, 14 (3).
e0214616.
ISSN 1932-6203
https://doi.org/10.1371/journal.pone.0214616
SGUL Authors: Finocchiaro, Gherardo
|
PDF
Published Version
Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
BACKGROUND: Persistent left ventricular (LV) systolic dysfunction in patients with acute lymphocytic myocarditis (LM) is widely unexplored. OBJECTIVES: To assess the frequency and predictors of persistent LV dysfunction in patients with LM and reduced LVEF at admission. METHODS AND RESULTS: We retrospectively evaluated 89 consecutive patients with histologically-proven acute myocarditis enrolled at three Italian referral hospitals. A subgroup of 48 patients with LM, baseline systolic impairment and an available echocardiographic assessment at 12 months (6-18) from discharge constituted the study population. The primary study end-point was persistent LV dysfunction, defined as LVEF <50% at 1-year, and was observed in 27/48 patients (56.3%). Higher LV end-diastolic diameter at admission (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.04-1.43, p = 0.002), non-fulminant presentation (OR 8.46, 95% CI 1.28-55.75, p = 0.013) and presence of a poor lymphocytic infiltrate (OR 12.40, 95% CI 1.23-124.97, p = 0.010) emerged as independent predictors of persistent LV dysfunction at multivariate analysis (area under the curve 0.91, 95% CI 0.82-0.99). Pre-discharge LVEF was lower in patients with persistent LV dysfunction compared to the others (32%±8 vs. 53%±8, p <0.001), and this single variable showed the best accuracy in predicting the study end-point (area under the curve 0.95, 95% CI 0.89-1.00). CONCLUSIONS: More than half of patients presenting with acute LM and LVEF <50% who survive the acute phase show persistent LV dysfunction after 1-year from hospital discharge. Features of subacute inflammatory process and of established myocardial damage at initial hospitalization emerged as predictors of this end-point.
Item Type: | Article |
---|---|
Additional Information: | © 2019 Merlo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
Keywords: | MD Multidisciplinary, General Science & Technology |
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: | PLoS One |
ISSN: | 1932-6203 |
Language: | eng |
Publisher License: | Creative Commons: Attribution 4.0 |
PubMed ID: | 30921422 |
Web of Science ID: | WOS:000462594000099 |
Go to PubMed abstract | |
URI: | https://openaccess.sgul.ac.uk/id/eprint/110846 |
Publisher's version: | https://doi.org/10.1371/journal.pone.0214616 |
Statistics
Actions (login required)
![]() |
Edit Item |