Ventricular arrhythmia in patients with acute myocarditis: A cohort study

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-07-26 DOI:10.1016/j.hrtlng.2025.07.018

Jasmin Büchel MD , Gianmarco M. Balestra MD , Alessia Schuler , Philip Haaf MD , Christian Mueller MD , Patrick Badertscher MD , Stephan Marsch PhD , Michael Kühne PhD , Christian Sticherling MD , Philipp Krisai MD

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引用次数: 0

Abstract

Background

Patients with acute myocarditis (AM) are at increased risk of arrhythmias.

Objectives

We aimed to characterize the timing and potential predictors associated with ventricular arrhythmias (VA).

Methods

A total of 351 consecutive patients hospitalized with AM on the intensive care unit with continuous monitoring between 2000–2023 were included into a retrospective cohort study. We analyzed predictors, temporal occurrence and different forms of VA in patients with AM.

Results

Mean age was 41.3 years and 74.4 % were men. Overall, 45 VA occurred in 36 (10.3 %) patients: 26 (58 %) non-sustained ventricular tachycardia (VT), 10 (22 %) sustained VT, 6 (13 %) cardiac arrest and 3 (7 %) ventricular fibrillation. The majority of VA (79 %) occurred within the first 24 h, but 11.9 % occurred only after 72 h. Among the analyzed variables cardiac troponin T (cTnT), left ventricular ejection fraction (LVEF), syncope at presentation and female sex were independent predictors for VA. A combined model including these four variables showed good discrimination, with an area under the curve of 0.80. Compared to patients without VA, patients with VA more often received advanced therapies (30.6 vs 5.7 %, p < 0.001), and experienced a higher rate of incident or worsening heart failure (52.8 vs 16.5 %, p < 0.001) and increased mortality (19.4 vs 0.3 %, p < 0.001).

Conclusion

In patients with AM, VA occur in 1 out of ten patients, most often manifested within the first 24 h. A model including cTnT, LVEF, syncope and female sex performed well in predicting VA.

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急性心肌炎患者室性心律失常：一项队列研究

背景：急性心肌炎（AM）患者发生心律失常的风险增加。目的探讨室性心律失常（室性心律失常，VA）发生的时间和潜在的预测因素。方法采用回顾性队列研究方法，选取2000-2023年在重症监护病房连续监测的351例AM患者。我们分析了AM患者的预测因素、时间发生和不同形式的VA。结果平均年龄41.3岁，男性占74.4%。总体而言，36例（10.3%）患者发生45例室性心动过速（VT）： 26例（58%）非持续性室性心动过速（VT）， 10例（22%）持续性室性心动过速，6例（13%）心脏骤停，3例（7%）心室颤动。在分析的变量中，心肌肌钙蛋白T （cTnT）、左室射血分数（LVEF）、出诊时晕厥和女性性别是VA的独立预测因子，包含这四个变量的联合模型具有良好的判别性，曲线下面积为0.80。与无房颤患者相比，房颤患者更常接受先进的治疗(30.6% vs 5.7%, p <；0.001)，并且经历了更高的心力衰竭发生率或恶化率(52.8 vs 16.5%, p <；0.001)和死亡率增加(19.4% vs 0.3%, p <；0.001)。结论AM患者中，1 / 10的患者发生VA，最常在前24 h内出现。cTnT、LVEF、晕厥和女性性别模型对VA的预测效果较好。

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

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.