BACKGROUND: The aim of this study was to analyse the long-term prognosis of patients with acute myocarditis (AMC) who had been discharged from hospital while having normal left ventricular (LV) function. METHODS AND RESULTS: 50 patients with acute myocarditis who underwent endomyocardial biopsies (EMBs) were prospectively studied. Their clinical condition was examined during a mean follow-up period of 72 (54-78) months, including tissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilated cardiomyopathy. 45/50 (90%) showed a normal or improvement in LV function over time. In the course of the follow-up, 49% (22/45) suffered from heart failure symptoms despite a normal ejection fraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired deceleration time of early mitral flow velocity and isovolumic relaxation time, and a pathological increase in the LV filling index E/E', in contrast to patients without heart failure symptoms (E/E'(septal) 10.9 (9.3-13.8) vs 6.8 (6.4-9.1); p=0.001). Plasma N-terminal proB-type natriuretic peptide levels were increased threefold in patients with HFNEF (19.9 (10.6-24.1) vs 7.3 (4.2-11.9) pmol/l; p=0.006). CONCLUSIONS: It is assumed that the evidence for AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after several years.
BACKGROUND: The aim of this study was to analyse the long-term prognosis of patients with acute myocarditis (AMC) who had been discharged from hospital while having normal left ventricular (LV) function. METHODS AND RESULTS: 50 patients with acute myocarditis who underwent endomyocardial biopsies (EMBs) were prospectively studied. Their clinical condition was examined during a mean follow-up period of 72 (54-78) months, including tissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilated cardiomyopathy. 45/50 (90%) showed a normal or improvement in LV function over time. In the course of the follow-up, 49% (22/45) suffered from heart failure symptoms despite a normal ejection fraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired deceleration time of early mitral flow velocity and isovolumic relaxation time, and a pathological increase in the LV filling index E/E', in contrast to patients without heart failure symptoms (E/E'(septal) 10.9 (9.3-13.8) vs 6.8 (6.4-9.1); p=0.001). Plasma N-terminal proB-type natriuretic peptide levels were increased threefold in patients with HFNEF (19.9 (10.6-24.1) vs 7.3 (4.2-11.9) pmol/l; p=0.006). CONCLUSIONS: It is assumed that the evidence for AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after several years.
Authors: Leonardo Italia; Giacomo Ingallina; Antonio Napolano; Antonio Boccellino; Martina Belli; Francesco Cannata; Marco Rolando; Francesco Ancona; Francesco Melillo; Stefano Stella; Marco Ripa; Paolo Scarpellini; Moreno Tresoldi; Alessandro Ortalda; Beatrice Righetti; Francesco De Cobelli; Antonio Esposito; Fabio Ciceri; Antonella Castagna; Patrizia Querini Rovere; Gabriele Fragasso; Eustachio Agricola Journal: Echocardiography Date: 2021-10-21 Impact factor: 1.724
Authors: Mohammad Said Ramadan; Lorenzo Bertolino; Rosa Zampino; Emanuele Durante-Mangoni Journal: Clin Microbiol Infect Date: 2021-06-23 Impact factor: 13.310
Authors: Carsten Tschöpe; Enrico Ammirati; Biykem Bozkurt; Alida L P Caforio; Leslie T Cooper; Stephan B Felix; Joshua M Hare; Bettina Heidecker; Stephane Heymans; Norbert Hübner; Sebastian Kelle; Karin Klingel; Henrike Maatz; Abdul S Parwani; Frank Spillmann; Randall C Starling; Hiroyuki Tsutsui; Petar Seferovic; Sophie Van Linthout Journal: Nat Rev Cardiol Date: 2020-10-12 Impact factor: 49.421
Authors: Mohammad Said Ramadan; Lorenzo Bertolino; Tommaso Marrazzo; Maria Teresa Florio; Emanuele Durante-Mangoni Journal: Intern Emerg Med Date: 2021-05-27 Impact factor: 3.397