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Fulminant Versus Ac...
Fulminant Versus Acute Nonfulminant Myocarditis in Patients With Left Ventricular Systolic Dysfunction
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- Ammirati, Enrico (author)
- Niguarda Hospital
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- Veronese, Giacomo (author)
- University of Milano-Bicocca,Niguarda Hospital
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- Brambatti, Michela (author)
- University of California, San Diego
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- Merlo, M. (author)
- University Hospital Of Trieste
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- Cipriani, Manlio (author)
- Niguarda Hospital
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- Potena, Luciano (author)
- St. Orsola-Malpighi University Hospital
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- Sormani, P. (author)
- Niguarda Hospital
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- Aoki, Tatsuo (author)
- Tohoku University
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- Sugimura, Koichiro (author)
- Tohoku University
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- Sawamura, Akinori (author)
- Nagoya University
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- Okumura, Takahiro (author)
- Nagoya University
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- Pinney, Sean (author)
- Icahn School of Medicine at Mount Sinai
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- Hong, Kimberly (author)
- University of California, San Diego
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- Shah, P. (author)
- Inova Heart and Vascular Institute
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- Braun, Öscar (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molecular Epidemiology and Cardiology,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- Van de Heyning, Caroline M. (author)
- Antwerp University Hospital
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- Montero, Santiago (author)
- Autonomous University of Barcelona,Pitié-Salpêtrière University Hospital
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- Petrella, Duccio (author)
- Niguarda Hospital
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- Huang, Florent (author)
- Pitié-Salpêtrière University Hospital
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- Schmidt, Matthieu (author)
- Pitié-Salpêtrière University Hospital
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- Raineri, Claudia (author)
- Policlinico San Matteo Pavia Fondazione
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- Lala, Anuradha (author)
- Icahn School of Medicine at Mount Sinai
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- Varrenti, Marisa (author)
- Niguarda Hospital,University of Milano-Bicocca
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- Foà, Alberto (author)
- St. Orsola-Malpighi University Hospital
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- Leone, Ornella (author)
- St. Orsola-Malpighi University Hospital
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- Gentile, P. (author)
- University Hospital Of Trieste
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- Artico, Jessica (author)
- University Hospital Of Trieste
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- Agostini, Valentina (author)
- St. Orsola-Malpighi University Hospital
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- Patel, R. (author)
- Inova Heart and Vascular Institute
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- Garascia, Andrea (author)
- Niguarda Hospital
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- Van Craenenbroeck, Emeline M. (author)
- Antwerp University Hospital
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- Hirose, K. (author)
- Kokura Memorial Hospital
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- Isotani, Akihiro (author)
- Kokura Memorial Hospital
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- Murohara, Toyoaki (author)
- Nagoya University
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- Arita, Yoh (author)
- Osaka City General Hospital
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- Sionis, Alessandro (author)
- Autonomous University of Barcelona
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- Fabris, Enrico (author)
- University Hospital Of Trieste
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- Hashem, Sherin (author)
- University of California, San Diego
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- Garcia-Hernando, Victor (author)
- Autonomous University of Barcelona
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- Oliva, Fabrizio (author)
- Niguarda Hospital
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- Greenberg, Barry H. (author)
- University of California, San Diego
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- Shimokawa, Hiroaki (author)
- Tohoku University
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- Sinagra, Gianfranco (author)
- University Hospital Of Trieste
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- Adler, Eric D. (author)
- University of California, San Diego
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- Frigerio, M. (author)
- Niguarda Hospital
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- Camici, Paolo G. (author)
- San Raffaele Scientific Institute
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(creator_code:org_t)
- Elsevier BV, 2019
- 2019
- English 13 s.
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In: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 74:3, s. 299-311
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http://dx.doi.org/10...
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Abstract
Subject headings
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- Background: Fulminant myocarditis (FM) is a form of acute myocarditis characterized by severe left ventricular systolic dysfunction requiring inotropes and/or mechanical circulatory support. A single-center study found that a patient with FM had better outcomes than those with acute nonfulminant myocarditis (NFM) presenting with left ventricular systolic dysfunction, but otherwise hemodynamically stable. This was recently challenged, so disagreement still exists. Objectives: This study sought to provide additional evidence on the outcome of FM and to ascertain whether patient stratification based on the main histologic subtypes can provide additional prognostic information. Methods: A total of 220 patients (median age 42 years, 46.3% female) with histologically proven acute myocarditis (onset of symptoms <30 days) all presenting with left ventricular systolic dysfunction were included in a retrospective, international registry comprising 16 tertiary hospitals in the United States, Europe, and Japan. The main endpoint was the occurrence of cardiac death or heart transplantation within 60 days from admission and at long-term follow-up. Results: Patients with FM (n = 165) had significantly higher rates of cardiac death and heart transplantation compared with those with NFM (n = 55), both at 60 days (28.0% vs. 1.8%, p = 0.0001) and at 7-year follow-up (47.7% vs. 10.4%, p < 0.0001). Using Cox multivariate analysis, the histologic subtype emerged as a further variable affecting the outcome in FM patients, with giant cell myocarditis having a significantly worse prognosis compared with eosinophilic and lymphocytic myocarditis. In a subanalysis including only adults with lymphocytic myocarditis, the main endpoints occurred more frequently in FM compared with in NFM both at 60 days (19.5% vs. 0%, p = 0.005) and at 7-year follow up (41.4% vs. 3.1%, p = 0.0004). Conclusions: This international registry confirms that patients with FM have higher rates of cardiac death and heart transplantation both in the short- and long-term compared with patients with NFM. Furthermore, we provide evidence that the histologic subtype of FM carries independent prognostic value, highlighting the need for timely endomyocardial biopsy in this condition.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- acute myocarditis
- endomyocardial biopsy
- eosinophilic myocarditis
- fulminant myocarditis
- giant cell myocarditis
- outcome
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Ammirati, Enrico
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Veronese, Giacom ...
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Brambatti, Miche ...
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Merlo, M.
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Cipriani, Manlio
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Potena, Luciano
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show more...
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Sormani, P.
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Aoki, Tatsuo
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Sugimura, Koichi ...
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Sawamura, Akinor ...
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Okumura, Takahir ...
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Pinney, Sean
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Hong, Kimberly
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Shah, P.
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Braun, Öscar
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Van de Heyning, ...
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Montero, Santiag ...
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Petrella, Duccio
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Huang, Florent
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Schmidt, Matthie ...
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Raineri, Claudia
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Lala, Anuradha
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Varrenti, Marisa
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Foà, Alberto
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Leone, Ornella
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Gentile, P.
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Artico, Jessica
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Agostini, Valent ...
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Patel, R.
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Garascia, Andrea
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Van Craenenbroec ...
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Hirose, K.
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Isotani, Akihiro
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Murohara, Toyoak ...
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Arita, Yoh
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Sionis, Alessand ...
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Fabris, Enrico
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Hashem, Sherin
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Garcia-Hernando, ...
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Oliva, Fabrizio
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Greenberg, Barry ...
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Shimokawa, Hiroa ...
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Sinagra, Gianfra ...
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Adler, Eric D.
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Frigerio, M.
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Camici, Paolo G.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of the A ...
- By the university
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Lund University