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Influence of echocardiographic measurements and renal impairments on the prognosis of fulminant myocarditis.

Abstract Fulminant myocarditis is a severe cardiac emergency that may lead to death if effective cardiopulmonary supports are not provided. This study aimed to evaluate the prognostic predictors in patients with fulminant myocarditis.We retrospectively analyzed the clinical characteristics, complications, laboratory findings, treatments, as well as electrocardiographic and echocardiographic data of 73 consecutive subjects diagnosed with fulminant myocarditis from June 2012 to June 2016. Logistic regression analysis was used to identify the independent predictive factors of nonsurvivor fulminant myocarditis.Ten patients and 63 patients were assigned to the nonsurvivor and survivor fulminant myocarditis groups, respectively. Patients in the nonsurvivor fulminant myocarditis group had higher heart rates; were more likely to develop clinical complications and supraventricular tachycardia (SVT); and had higher serum creatinine (Scr) level, and had higher white blood cell (WBC) counts, and lower abbreviated estimated glomerular filtration rates (eGFR) than the patients in the survivor fulminant myocarditis group. Moreover, we observed larger left atrium dimension (LAd), larger left ventricular end systolic dimensions, and lower left ventricular ejection fraction in the patients from the nonsurvivor fulminant myocarditis group than in those from the other group. A logistic regression model was constructed and demonstrated that eGFR and LAd were 2 independent predictors of mortality in patients with fulminant myocarditis.Higher heart rates, higher incidences of clinical complication, SVT, higher admission levels of Scr and eGFR, higher WBC counts, higher Scr and eGFR at stage of most severe renal damage, and abnormal echocardiographic findings were associated with high risk of mortality in patients with fulminant myocarditis. The major finding was that eGFR and LAd were independent predictors for in-hospital mortality in patients with fulminant myocarditis.
PMID
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Authors

Mayor MeshTerms

Echocardiography

Keywords
Journal Title medicine
Publication Year Start




PMID- 29384884
OWN - NLM
STAT- MEDLINE
DCOM- 20180209
LR  - 20180209
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Influence of echocardiographic measurements and renal impairments on the
      prognosis of fulminant myocarditis.
PG  - e9812
LID - 10.1097/MD.0000000000009812 [doi]
AB  - Fulminant myocarditis is a severe cardiac emergency that may lead to death if
      effective cardiopulmonary supports are not provided. This study aimed to evaluate
      the prognostic predictors in patients with fulminant myocarditis.We
      retrospectively analyzed the clinical characteristics, complications, laboratory 
      findings, treatments, as well as electrocardiographic and echocardiographic data 
      of 73 consecutive subjects diagnosed with fulminant myocarditis from June 2012 to
      June 2016. Logistic regression analysis was used to identify the independent
      predictive factors of nonsurvivor fulminant myocarditis.Ten patients and 63
      patients were assigned to the nonsurvivor and survivor fulminant myocarditis
      groups, respectively. Patients in the nonsurvivor fulminant myocarditis group had
      higher heart rates; were more likely to develop clinical complications and
      supraventricular tachycardia (SVT); and had higher serum creatinine (Scr) level, 
      and had higher white blood cell (WBC) counts, and lower abbreviated estimated
      glomerular filtration rates (eGFR) than the patients in the survivor fulminant
      myocarditis group. Moreover, we observed larger left atrium dimension (LAd),
      larger left ventricular end systolic dimensions, and lower left ventricular
      ejection fraction in the patients from the nonsurvivor fulminant myocarditis
      group than in those from the other group. A logistic regression model was
      constructed and demonstrated that eGFR and LAd were 2 independent predictors of
      mortality in patients with fulminant myocarditis.Higher heart rates, higher
      incidences of clinical complication, SVT, higher admission levels of Scr and
      eGFR, higher WBC counts, higher Scr and eGFR at stage of most severe renal
      damage, and abnormal echocardiographic findings were associated with high risk of
      mortality in patients with fulminant myocarditis. The major finding was that eGFR
      and LAd were independent predictors for in-hospital mortality in patients with
      fulminant myocarditis.
FAU - Xu, Mingzhu
AU  - Xu M
AD  - Department of Cardiology, The First Affiliated Hospital of Soochow University,
      Suzhou, Jiangsu, P.R. China.
FAU - Jiang, Tingbo
AU  - Jiang T
FAU - Zhou, Yafeng
AU  - Zhou Y
FAU - Yang, Xiangjun
AU  - Yang X
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - *Echocardiography
MH  - Electrocardiography
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocarditis/*complications/*diagnostic imaging/mortality
MH  - Prognosis
MH  - Renal Insufficiency/*complications/diagnosis/mortality
MH  - Retrospective Studies
EDAT- 2018/02/01 06:00
MHDA- 2018/02/10 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/10 06:00 [medline]
AID - 10.1097/MD.0000000000009812 [doi]
AID - 00005792-201802020-00046 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9812. doi: 10.1097/MD.0000000000009812.