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Fulminant myocarditis proven by early biopsy and outcomes
F. Huang, E. Ammirati, M. Ponnaiah, S. Montero, V. Raimbault, D. Abrams, G. Lebreton, V. Pellegrino, J. Ihle, M. Bottiroli, R. Persichini, MI. Barrionuevo-Sánchez, A. Ariza-Solé, PY. Ng, SWC. Sin, R. Ayer, H. Buscher, S. Belaid, C. Delmas, R....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
NLK
Free Medical Journals
od 1996 do Před 1 rokem
Open Access Digital Library
od 1996-01-01
- MeSH
- biopsie metody MeSH
- dospělí MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- myokard patologie MeSH
- myokarditida * komplikace MeSH
- retrospektivní studie MeSH
- srdeční katetrizace MeSH
- transplantace srdce * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND AIMS: While endomyocardial biopsy (EMB) is recommended in adult patients with fulminant myocarditis, the clinical impact of its timing is still unclear. METHODS: Data were collected from 419 adult patients with clinically suspected fulminant myocarditis admitted to intensive care units across 36 tertiary centres in 15 countries worldwide. The diagnosis of myocarditis was histologically proven in 210 (50%) patients, either by EMB (n = 183, 44%) or by autopsy/explanted heart examination (n = 27, 6%), and clinically suspected cardiac magnetic resonance imaging confirmed in 96 (23%) patients. The primary outcome of survival free of heart transplantation (HTx) or left ventricular assist device (LVAD) at 1 year was specifically compared between patients with early EMB (within 2 days after intensive care unit admission, n = 103) and delayed EMB (n = 80). A propensity score-weighted analysis was done to control for confounders. RESULTS: Median age on admission was 40 (29-52) years, and 322 (77%) patients received temporary mechanical circulatory support. A total of 273 (65%) patients survived without HTx/LVAD. The primary outcome was significantly different between patients with early and delayed EMB (70% vs. 49%, P = .004). After propensity score weighting, the early EMB group still significantly differed from the delayed EMB group in terms of survival free of HTx/LVAD (63% vs. 40%, P = .021). Moreover, early EMB was independently associated with a lower rate of death or HTx/LVAD at 1 year (odds ratio of 0.44; 95% confidence interval: 0.22-0.86; P = .016). CONCLUSIONS: Endomyocardial biopsy should be broadly and promptly used in patients admitted to the intensive care unit for clinically suspected fulminant myocarditis.
Acute Cardiac Care Unit Department of Cardiology Hospital Marqués de Valdecilla Santander Spain
Adult Intensive Care Unit Queen Mary Hospital Hong Kong China
Cardiology Department Complejo Hospitalario Universitario de A Coruña CIBERCV A Coruña Spain
De Gasperis Cardio Center and Transplant Center Niguarda Hospital Milan Italy
Departement of Infectious Diseases and Intensive Care Unit Pontchaillou Hospital Rennes 35200 France
Department of Anaesthesiology and Intensive Care General University Hospital Prague Czech Republic
Department of Anaesthesiology The University of Hong Kong Hong Kong China
Department of Anesthesiology and Critical Care CHU Rouen Rouen F 76000 France
Department of Cardiology Clínica Las Condes Las Condes Chile
Department of Cardiology Foch Hospital Suresnes France
Department of Cardiology Hospital Clínic Barcelona Barcelona Spain
Department of Cardiology Hospital Universitario La Paz IDIPAZ Madrid Spain
Department of Cardiology Rangueil University Hospital Toulouse France
Department of Thoracic and Cardiovascular Surgery Korea University Anam Hospital Seoul South Korea
Intensive Care Center University Medical Center Utrecht Utrecht The Netherlands
Intensive Care Department Hospital Alvaro Cunqueiro Vigo Spain
Intensive Care Unit Alfred Hospital Melbourne Australia
Intensive Care Unit Erasme Hospital Brussels Belgium
Intensive Care Unit Guy's and St Thomas' NHS Foundation Trust Hospital London UK
Intensive Care Unit Hallym University Sacred Heart Hospital Anyang South Korea
Intensive Care Unit Jean Minjoz Hospital Besançon France
Intensive Care Unit Saint João Hospital Porto Portugal
Intensive Care Unit St Vincent Hospital Sydney Australia
Intensive Care Unit University Medical Centre Regensburg Regensburg Germany
Medical Intensive Care Unit Assistance Publique Hôpitaux de Paris Mondor Hospital Créteil France
Medical Surgical Intensive Care Unit Félix Guyon Hospital CHU de La Réunion France
Sorbonne Université INSERM UMRS_1166 iCAN Institute of Cardiometabolism and Nutrition Paris France
Citace poskytuje Crossref.org
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