Clinical Features and Outcomes of Fulminant Myocarditis Revealed by a National Cohort Study

Myocarditis is an inflammatory disease of the myocardium often caused by viral infections or autoimmune disorders. Fulminant myocarditis (MF) is a rare and serious manifestation of myocarditis characterized by hemodynamic instability requiring inotropes and/or mechanical circulatory support. The natural history of FM and its clinical features are incompletely understood due to the lack of generalizable data.

A team of researchers from Nara Medical University and the National Brain and Cardiovascular Center conducted a nationwide cohort study of patients with histologically proven FM, at 235 cardiovascular hospitals in Japan. They revealed that the 90-day mortality was 29% and that some specific clinical findings, such as advanced age, non-sinus rhythm on admission, left ventricular ejection fraction

« A comprehensive assessment of clinical and pathological findings can aid in the prediction of outcome in patients with FM. Our results showed that approximately half of patients with a clinical diagnosis of FM did not undergo endomyocardial biopsy, and increasing biopsy implementation may improve FM management.» – Dr. Koshiro Kanaoka.

The next steps in this research are to clarify the effective treatment and the immunological mechanism of inflammation in patients with FM.

The research has been published in Circulationle journal officiel de l’American Heart Association, sous le titre « Features and Outcomes of Histologically Proven Myocarditis with Fulminant Presentation » (DOI : 10.1161/CIRCULATIONAHA.121.058869).

This research was supported by grant 21ek0109528 from the Japan Agency for Medical Research and Development and grant 20K08453 from the Japan Society for the Promotion of Science KAKENHI.

Source :

National Cerebral and Cardiovascular Center

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