Acute myocarditis according to age: Presentation, management and early outcomes.

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

ESC Heart Failure Pub Date : 2025-05-22 DOI:10.1002/ehf2.15304

Clément Karsenty, Paul Vignaud, Clara Brusq, Pamela Moceri, Pascal Lim, Edouard Gerbaud, Olivier Lairez, Coline Lelarge, Caroline Ovaert, Claire Bouleti, Oscar Werner, Vanina Bongard, Thibaud Genet, Laurent Bonnemains, Christophe Tron, Elise Barre, Margaux Boddaert, Jacques Mansourati, Chérine Benzouid, François Roubille, Hadi Khachab, Sabrina Uhry, Ariel Cohen, Benoit Lattuca, Sylvie Di Filippo, Clément Delmas

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引用次数: 0

Abstract

Aims: Acute myocarditis (AM) is a rare but severe disease affecting patients of all ages. Large multicentric studies comparing children and adults are currently lacking. We aimed to elucidate differences in presentation, management, and outcomes of AM across age groups.

Methods: We analysed a comprehensive French national cohort study, encompassing 53 paediatric and adult units from March 2020 to November 2021, collecting data on baseline characteristics, evolution, management and in-hospital complications. Myocarditis-related events (MRE) within 30 days included all-cause death, cardiogenic shock, cardiac arrest, ventricular arrhythmias or complete AV block.

Results: We included 745 AM patients (328 children and 417 adults), mainly male (73.4%) with a median age of 10.9 years [Q1-Q3 (7.3-14.6)] for children and 28.7 years [22.6-41.2] for adults. Multisystem inflammatory syndrome (MIS) was more prevalent among children (69.8%), and infectious aetiologies dominated in adults (13.4 vs. 52.4%). Children exhibited more severe clinical presentation (15.9 vs. 7.2%, P < 0.001, with heart failure and 14.4 vs. 6.9%, P < 0.001, with cardiogenic shock), requiring higher use of inotropes (25.0 vs. 9.4%, P < 0.001), vasopressors (12.0 vs. 6.2%, P < 0.001), and ventilatory support (13.7% vs. 7.9%, P = 0.01). Cardiac treatments were used less frequently in children, and corticosteroids (68.3 vs, 14.3, P < 0.001) and immunomodulators (65.1 vs. 4.5%, P < 0.001) were more common. MRE occurrence was substantial but not significantly different between children and adults (18.1 vs. 13.4%, P = 0.09). Extra-cardiac manifestations at admission were significant predictors of MRE [adjusted odds ratio 2.40 (1.43-4.38)], regardless of MIS status.

Conclusions: AM exhibits variations in presentation, aetiologies and management but has a comparable 30 day prognosis in children and adults. These findings underscore the importance of tailored management strategies in AM across different age groups.

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急性心肌炎的年龄：表现，处理和早期结果。

目的：急性心肌炎（AM）是一种罕见但严重的疾病，影响所有年龄的患者。目前缺乏比较儿童和成人的大型多中心研究。我们的目的是阐明不同年龄组AM的表现、管理和结果的差异。方法：我们分析了一项全面的法国国家队列研究，包括2020年3月至2021年11月期间的53个儿科和成人单位，收集了基线特征、演变、管理和院内并发症的数据。30天内心肌炎相关事件（MRE）包括全因死亡、心源性休克、心脏骤停、室性心律失常或完全性房室传导阻滞。结果：我们纳入了745例AM患者（328例儿童，417例成人），主要为男性（73.4%），儿童中位年龄为10.9岁[Q1-Q3(7.3-14.6)]，成人中位年龄为28.7岁[22.6-41.2]。多系统炎症综合征（MIS）在儿童中更为普遍（69.8%），感染病因在成人中占主导地位（13.4%比52.4%）。儿童表现出更严重的临床表现（15.9% vs. 7.2%， P）结论：AM在表现、病因和治疗方面存在差异，但儿童和成人的30天预后相当。这些发现强调了在不同年龄组的AM中定制管理策略的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine

CiteScore

7.00

自引率

7.90%

发文量

461

审稿时长

12 weeks

期刊介绍： ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.