Endomyocardial biopsy: safety and prognostic utility in paediatric and adult myocarditis in the European Society of Cardiology EURObservational Research Programme Cardiomyopathy and Myocarditis Long-Term Registry

医学 心肌炎 心脏移植 心肌病 心脏病学 内科学 移植 扩张型心肌病 活检 心脏磁共振成像 磁共振成像 心力衰竭 放射科
作者
Alida L.P. Caforio,Juan Pablo Kaski,Juan R. Gimeno,Perry Elliott,Cécile Laroche,Luigi Tavazzi,Michał Tendera,Michael Fu,Simone Sala,Petar Seferović,Tiina Heliö,Leonardo Caló,О. В. Благова,Ahmad Amin,Ingrid Kindermann,Gianfranco Sinagra,Andrea Frustaci,D Bonnet,Philippe Charron,Aldo P. Maggioni,Roberto Ferrari,Alvaro Alonso,Jeroen J. Bax,Carina Blomström‐Lundqvist,Stephan Gielen,Patrizio Lancellotti,Aldo P. Maggioni,Nikos Maniadakis,Fausto J. Pinto,Frank Ruschitzka,Luigi Tavazzi,Panos Vardas,Franz Weidinger,Uwe Zeymer,Alec Vahanian,Andrzej Budaj,Nikolaos Dagres,Nicolas Danchin,Victoria Delgado,Jonathan Emberson,Örjan Friberg,Chris P Gale,Gr. Heyndrickx,Bernard Iung,Stefan James,A. Pieter Kappetein,Aldo P. Maggioni,Nikos Maniadakis,Klaudia Vivien Nagy,G Parati,A-S Petronio,Mikko Pietilä,Eva Prescott,Frank Ruschitzka,Frans Van de Werf,Franz Weidinger,Uwe Zeymer,Chris P Gale,B. Beleslin,Andrzej Budaj,Ovidiu Chioncel,Nikolaos Dagres,Nicolas Danchin,Jonathan Emberson,David Erlinge,Michael Glikson,Alastair Gray,Meral Kayıkçıoğlu,Aldo P. Maggioni,Klaudia Vivien Nagy,А. О. Недошивин,A-P Petronio,Jolien W. Roos‐Hesselink,Lars Wallentin,Uwe Zeymer,Bogdan A. Popescu,David Adlam,Alida L.P. Caforio,Davide Capodanno,Marc R. Dweck,David Erlinge,Michael Glikson,Jörg Hausleiter,Bernard Iung,Meral Kayıkçıoğlu,Peter Ludman,Lars H. Lund,Aldo P. Maggioni,С.Т. Мацкеплишвили,Benjamin Meder,Klaudia Vivien Nagy,А. О. Недошивин,Danilo Neglia,Agnès Pasquet,Jolien W. Roos‐Hesselink,Fernando J. Rossello,Sameh Shaheen,Aleksandra Torbica,Alida L.P. Caforio,Juan R. Gimeno,Philippe Charron,Perry Elliott,Juan Pablo Kaski,Aldo P. Maggioni,Luigi Tavazzi,Michał Tendera,Jaana Pihkala,Tiina Ojala,Anita Hiippala,Teppo L. N. Järvinen,Jyri Lommi,Tiina Heliö,Juha Sinisalo,Damien Bonnet,Diala Khraiche,Isabelle Szézépanski,Philippe Charron,Stefan Mankikian,Carole Maupain,J-P Collet,Estelle Gandjbakhch,Mathieu Kerneïs,J.F. Pruny,Anna Bauer,Barbara Pfeiffer,S B Felix,Daniel Beug,Marcus Dörr,S Kaczmarek,Kristin Lehnert,A. K. Pedersen,Michael Bruder,Matthias Gorenflo,Richard Arnold,Sebastian Uhl,Victoria C. Ziesenitz,A. Jung,E. Roesch,Michael Böhm,Ingrid Kindermann,Yvonne Linicus,Christian Werner,B Neurath,M Schild-Ungerbuehler,Michael Kindermann,Juan Pablo Kaski,Gabrielle Norrish,Ella Field,Perry Elliott,Massimiliano Lorenzini,Oliver Watkinson,Eleanor Wicks,Aris Anastasakis,K Ritsatos,V Vlagkouli,S. Rammos,Georgios Kourelis,Anastasia Giannakopoulou,Evangelos Karanasios,Panagiotis Papachristou,G. Papadopoulos,George Servos,Majid Maleki,F Noohi Bezanjani,Ahmad Amin,Nasim Naderi,Mozhgan Parsaee,Sepideh Taghavi,Behshid Ghadrdoost,Sahar Jafari,Meysam Khoshavi,Paolo Della Bella,Simone Sala,Giovanni Peretto,Raffaele Calabrò,Giuseppe Pacileo,Maria Giovanna Russo,Giuseppe Limongelli,Augusto Esposito,Felice Gragnano,Rita Gravino,Tommaso Marrazzo,Daniele Masarone,Vittorio Pazzanese,Marta Rubino,Stefania Tramonte,Fabio Valente,Martina Caiazza,Paolo Calabrò,Annapaola Cirillo,Bruno Trimarco,M-A Losi,Carlo Di Nardo,A Giamundo,F Pacelli,Grazia Canciello,Sabino Iliceto,Alida L.P. Caforio,Chiara Calore,Loira Leoni,Martina Perazzolo Marra,Ilaria Rigato,Giuseppe Tarantini,Alessandro Schiavo,Martina Testolina,Francesco Fedele,Andrea Frustaci,Maria Alfarano,Cristina Chimenti,Fabrizio Drago,Anwar Baban,Leonardo Caló,Chiara Lanzillo,Annamaria Martino,Mariagrazia Uguccioni,Elisabetta Zachara,Géza Halász,Federica Re,Gianfranco Sinagra,Cosimo Carriere,Marco Merlo,Federica Ramani,Aušra Kavoliūnienė,Aušra Krivickienė,Eglė Tamulevičiūtė-Prascienė,Mindaugas Vieželis,Jelena Čelutkienė,L Balkeviciene,Monika Laukytė,Eglė Palevičiūtė,Folkert W. Asselbergs,Nicolaas de Jonge,J. H. Kirkels,Joris van der Heijden,L Van Laake,Arjan Sammani,Katarzyna Mizia­‐Stec,Michał Tendera,Maciej Wybraniec,A Czekaj,A. Sikora-Puz,Anna Skoczyńska,Paweł Rubiś,Sylwia Wiśniowska‐Śmiałek,Jacek Grzybowski,Natalia Ojrzyńska,Zofia T. Bilińska,Przemysław Chmielewski,Bogna Foss-Nieradko,Ewa Michalak,Małgorzata Stępień‐Wojno,B Mazek,Grażyna Brzezińska‐Rajszys,Lidia Ziółkowska,Agnieszka Boruc,E Plodzien,Luís R. Lopes,A R Almeida,Inês Cruz,Ana Catarina Gomes,Ana Rita Pereira,Carmen Ginghină,Ruxandra Jurcuţ,Eduard Apetrei,Sebastian Militaru,Ioan Mircea Coman,A Mursa,Bogdan A. Popescu,Attila Frigy,Lajos Fehérvári,Zoltán Fogarasi,Ildikó Kocsis,István Adorján Szabó,И. Г. Никитин,Ernesto Resnik,Maria Komissarova,V.B. Lazarev,M Shebzukhova,D. V. Ustyuzhanin,О. В. Благова,Irina B. Alieva,V Kulikova,Yu. A. Lutokhina,E. V. Pavlenko,N. V. Varionchik,E. V. Zaklyazminskaya,Dzemeshkevich Sl,Е. А. Колбасова,N.P. Kotlukova,Valeria Rusinova,Arsen Ristić,Petar Seferović,Aleksandra Pavlović,Goran Radovanović,Dejan Simeunović,Ivana Živković,Ivan Milinković,Ferrán Gran,Ferran Rosés‐Noguer,Dimpna C. Albert,Ángel Cequier,Joel Salazar‐Mendiguchía,Joseph E. Gonzalez,Nicolás Manito,Pablo García‐Pavía,Abelardo Morales Briceño,Marta Cobo‐Marcos,Fernándo Domínguez,Juan Ramòn Gimeno Blanes,F J Castro,Carmen Muñoz Esparza,M Sabater Molina,M Sorli García,David López Cuenca,Tomás Ripoll‐Vera,J. Álvarez,Julio Núñez,Y. Gómez,P L Sanchez Fernandez,Eduardo Villacorta,C Avila,Loreto Bravo,Elena Díaz-Peláez,María Gallego‐Delgado,Luisa Álvarez,Beatriz Plata-Izquierdo,Michael Fu,Uğur Canpolat
出处
期刊:European Heart Journal [Oxford University Press]
卷期号:45 (28): 2548-2569 被引量:4
标识
DOI:10.1093/eurheartj/ehae169
摘要

Abstract Background and Aims Contemporary multicentre data on clinical and diagnostic spectrum and outcome in myocarditis are limited. Study aims were to describe baseline features, 1-year follow-up, and baseline predictors of outcome in clinically suspected or biopsy-proven myocarditis (2013 European Society of Cardiology criteria) in adult and paediatric patients from the EURObservational Research Programme Cardiomyopathy and Myocarditis Long-Term Registry. Methods Five hundred eighty-one (68.0% male) patients, 493 adults, median age 38 (27–52) years, and 88 children, aged 8 (3–13) years, were divided into 3 groups: Group 1 (n = 233), clinically suspected myocarditis with abnormal cardiac magnetic resonance; Group 2 (n = 222), biopsy-proven myocarditis; and Group 3 (n = 126) clinically suspected myocarditis with normal or inconclusive or no cardiac magnetic resonance. Baseline features were analysed overall, in adults vs. children, and among groups. One-year outcome events included death/heart transplantation, ventricular assist device (VAD) or implantable cardioverter defibrillator (ICD) implantation, and hospitalization for cardiac causes. Results Endomyocardial biopsy, mainly right ventricular, had a similarly low complication rate in children and adults (4.7% vs. 4.9%, P = NS), with no procedure-related death. A classical myocarditis pattern on cardiac magnetic resonance was found in 31.3% of children and in 57.9% of adults with biopsy-proven myocarditis (P < .001). At 1-year follow-up, 11/410 patients (2.7%) died, 7 (1.7%) received a heart transplant, 3 underwent VAD (0.7%), and 16 (3.9%) underwent ICD implantation. Independent predictors at diagnosis of death or heart transplantation or hospitalization or VAD implantation or ICD implantation at 1-year follow-up were lower left ventricular ejection fraction and the need for immunosuppressants for new myocarditis diagnosis refractory to non–aetiology-driven therapy. Conclusions Endomyocardial biopsy was safe, and cardiac magnetic resonance using Lake Louise criteria was less sensitive, particularly in children. Virus-negative lymphocytic myocarditis was predominant both in children and adults, and use of immunosuppressive treatments was low. Lower left ventricular ejection fraction and the need for immunosuppressants at diagnosis were independent predictors of unfavourable outcome events at 1 year.
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