Long-term prognosis and risk factors for impaired heart function in patients with fulminant myocarditis or without fulminant myocarditis
Pei Ruihui
Wang Min
Abstract：Objective To discuss the difference in long-term prognosis in patients with fulminant myocarditis(FM)and patients without FM,and to analyze influence factors related to impaired heart function.Methods The patients with acute myocarditis discharged after successful rescue were chosen by using retrospective analysis,including 63 cases of FM(FM group)and 42 cases of non-FM(NFM group).The medical history materials were collected from the patients,and long-term prognosis was followed up and compared.Echocardiography was rechecked and analyzed in FM patients after they were discharged.The clinical materials were compared between patients with normal heart function and patients with impaired heart function.The influence factors of impaired heart function were analyzed.Results Compared with NFM group,in FM group age was elder,admission systolic blood pressure(SBP)and diastolic blood pressure(DBP)were lower,levels of white blood cell count(WBC),neutrophil count(NEUT),C-reactive protein(CRP),procalcitonin(PCT),cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP)and D-dimer(D-D)and percentage of the lowest value of admission left ventricular ejection fraction(LVEF)＜55%were higher,and LVEF recovery time was longer(P＜0.05).The differences in admission left atrial diameter(LAD)and left ventricular end-diastolic diameter(LVEDD)had no statistical significance between 2 groups(P>0.05).The levels of interventricular septal thickness(IVST)and left ventricular posterior wall thickness(LVPWTT)were higher,and levels of stroke volume(SV)and LVEF were lower in FM group than those in NFM group(P＜0.05).There were 16 patients(25.40%)with impaired heart function in FM group and 2(4.76%)in NFM group(P＜0.05).The FM group was further divided into impaired heart function subgroup and normal heart function subgroup.The recovery time of LVEF was longer and percentage of discharge LVEF＜55%was higher in impaired heart function subgroup than those in normal heart function subgroup(P＜0.05).The results of multi-factor analysis showed that recovery time of LVEF was an independent risk factor for impaired heart function during follow-up period in FM patients(HR=1.202,95%CI:1.101～1.592,P=0.017).Conclusion The long-term prognosis is poorer and incidence of impaired heart function is higher in FM patients compared with NFM patients.The longer recovery time of LVEF during hospitalization is an independent risk factor for impaired heart function after patients discharged.
Keywords：Fulminant myocarditisNon-fulminant myocarditisLong-term prognosisImpaired heart function
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1359-1362,1368 )