Long-term left ventricular ejection function in fulminant and non-fulminant myocarditis: A multicenter study in China

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-06-30 DOI:10.1016/j.ijcha.2025.101738

Guangling Li , Jing Zhang , Zheng Xu , Yaogui Ning , Li Zhang , Jing Yang , Gang Chen , Fan Li , Jiangang Jiang

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引用次数: 0

Abstract

Background

There is a gap regarding comparisons of left ventricular ejection fraction (LVEF) changes between fulminant myocarditis (FM) and non-FM (NFM) patients at different follow-up intervals.

Methods

This multicenter retrospective study included 324 patients (163 FM and 161 NFM) with confirmed acute myocarditis through endomyocardial biopsy (EMB) or cardiac magnetic resonance imaging. We used multi-model adjustment approach and a mixed-effects model to comprehensively evaluate changes in LVEF in FM relative to NFM, considering both dichotomous outcome (primary outcome) and repeated measurements outcome (secondary outcome). Sensitivity analysis was conducted for patients aged 15 years and older.

Results

FM patients exhibited a higher risk of the primary outcome (LVEF < 55 % at the last two follow-up visits) compared to NFM patients, with an odds ratio (OR) of 8.517 (95 % CI, 4.666–16.552; P < 0.001). Following comprehensive adjustment for confounders, the OR for FM versus NFM was 7.438 (95 % CI, 3.967–14.763; P < 0.001). Analysis of repeated measurements (secondary outcome) revealed that LVEF in the NFM group surpassed that in the FM group at different follow-up time points. Consistent findings were observed in the sensitivity analysis population. Additionally, after adjusting for potential confounders, intra-aortic ballon pump (IABP) and extracorporeal membrane oxygenation (ECMO) demonstrated OR values of 0.030 (95 % CI: 0.002–0.197; P = 0.001) and 0.339 (95 % CI: 0.124–0.880; P = 0.030) in patients with FM, respectively.

Conclusion

FM patients face a lower LVEF compared to NFM patients across various follow-up intervals. Additionally, early application of IABP and ECMO can enhance long-term LVEF in patients with FM.

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暴发性和非暴发性心肌炎的长期左心室射血功能：中国的一项多中心研究

背景：暴发性心肌炎（FM）和非FM （NFM）患者在不同随访时间内左室射血分数（LVEF）变化的比较存在差异。方法本多中心回顾性研究纳入324例经心肌内膜活检（EMB）或心脏磁共振成像确诊的急性心肌炎患者（163例FM和161例NFM）。我们采用多模型调整方法和混合效应模型，综合评估FM患者相对于NFM患者LVEF的变化，同时考虑到二分类结局（主要结局）和重复测量结局（次要结局）。对15岁及以上患者进行敏感性分析。结果fm患者主要转归(LVEF <；与NFM患者相比，优势比（OR）为8.517 (95% CI, 4.666-16.552；P & lt;0.001)。综合校正混杂因素后，FM与NFM的OR为7.438 (95% CI, 3.967-14.763；P & lt;0.001)。重复测量分析（次要结局）显示，在不同随访时间点，NFM组的LVEF均优于FM组。在敏感性分析人群中观察到一致的结果。此外，在调整潜在混杂因素后，主动脉内气囊泵（IABP）和体外膜氧合（ECMO）的OR值为0.030 (95% CI: 0.002-0.197；P = 0.001)和0.339 (95% CI: 0.124-0.880；P = 0.030)。结论在不同随访时间内，fm患者的LVEF低于NFM患者。此外，早期应用IABP和ECMO可提高FM患者的长期LVEF。

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

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.