Predictors of disease course in patients with acute myocarditis

K Fuse ¹, M Kodama , Y Okura

⁰First Department of Internal Medicine, Niigata University School of Medicine, Niigata, Japan.

Circulation +

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January 11, 2000

View abstract on PubMed

Summary

Predicting acute myocarditis outcomes is crucial. Elevated serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) at presentation indicate a poorer prognosis in myocarditis patients.

Area Of Science

Cardiology
Immunology
Pathology

Background

Acute myocarditis presents with variable clinical outcomes, ranging from asymptomatic to fatal.
Predictors for disease course in acute myocarditis patients at initial presentation remain unestablished.

Purpose Of The Study

To investigate the predictive value of various parameters for the disease course in patients with acute myocarditis.

Main Methods

Histological examination confirmed acute myocarditis in 21 patients, divided into survival (n=13) and fatal (n=8) groups.
Clinical, hemodynamic, therapeutic, biochemical, and cytokine parameters were analyzed.
Control groups included patients with old myocardial infarction (n=23) and healthy volunteers (n=20).

Main Results

The fatal group exhibited lower blood pressure and higher pulmonary capillary wedge pressure than the survival group.
Mechanical ventilation was more frequently required in the fatal group.
Serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) were significantly elevated in the myocarditis group compared to controls, and further elevated in the fatal group versus the survival group (P<0.001 for sFas, P<0.05 for sFasL).

Conclusions

Elevated serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) at initial presentation serve as effective serological markers for predicting the prognosis of acute myocarditis.

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