Predictors of Outcome in Patients With Suspected Myocarditis

• DOI: 10.1161/circulationaha.108.769489
• Publication Date: 2008-07-22T00:54:14Z
• Authors: Ingrid Kindermann; Michael Kindermann; Reinhard Kandolf; Karin Klingel; Burkhard Bültmann; Thomas Müller; Angelika Lindinger; Michael Böhm
• Keywords: Viral Myocarditis; Univariate analysis

Background— The objective of this study was to identify the prognostic indicators in patients with suspected myocarditis who underwent endomyocardial biopsy. Methods and Results— Between 1994 2007, 181 consecutive (age, 42±15 years) clinically viral were enrolled followed up for a mean 59±42 months. Endomyocardial biopsies studied inflammation histological (Dallas) immunohistological criteria. Virus genome detected by polymerase chain reaction. primary end point time cardiac death or heart transplantation. In 38% (n=69), Dallas criteria positive. Immunohistological signs shown 50% (n=91). Genomes cardiotropic virus species 79 (44%). During follow-up, 22% (n=40) reached point. Three independent predictors identified point, namely New York Heart Association class III IV at entry (hazard ratio, 3.20; 95% confidence interval, 1.36 7.57; P =0.008), evidence inflammatory infiltrates myocardium 3.46; 1.39 8.62; β-blocker therapy 0.43; 0.21 0.91; =0.027). Ejection fraction, left ventricular end-diastolic pressure, dimension index predictive only univariate, not multivariate, analysis. Neither nor detection predictor outcome. Conclusions— For myocarditis, advanced functional class, inflammation, lack therapy, but histology (positive criteria) detection, are related poor