Long-term outcome and its predictors in giant cell myocarditis

Related Experiment Video

Updated: Mar 18, 2026

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

7.7K

Kaj Ekström1, Jukka Lehtonen1, Riina Kandolin1

  • 1Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland.

European Journal of Heart Failure
|July 14, 2016
PubMed

Insights

Giant cell myocarditis (GCM) survival is 42% at 5 years. Left ventricular ejection fraction, NT-proBNP, troponin-T, and myocardial biopsy findings predict transplant-free survival in GCM patients.

Area of Science:

  • Cardiology
  • Pathology
  • Transplantation Medicine

Background:

  • Giant cell myocarditis (GCM) is a rare and aggressive form of heart muscle inflammation.
  • Prognostic factors for transplant-free survival in GCM have not been well-established.
  • Identifying predictors is crucial for guiding clinical management and improving patient outcomes.

Purpose of the Study:

  • To identify predictors of transplant-free survival in patients diagnosed with giant cell myocarditis.
  • To analyze the association between clinical characteristics, laboratory data, and myocardial histology with patient outcomes.

Main Methods:

  • Retrospective analysis of 46 GCM patients diagnosed between 1991 and 2015.
  • Evaluation of patient demographics, admission laboratory values (including NT-proBNP, troponin-T), and left ventricular ejection fraction (LVEF).
  • Histopathological assessment of myocardial biopsies for necrosis and fibrosis severity in 38 patients.

Main Results:

  • The 5-year transplant-free survival rate was 42%.
  • Increased LVEF (HR 0.87 per 5% increase), elevated NT-proBNP (HR 1.06 per 1000 ng/L increase), and high cardiac troponin-T levels (HR 4.57 above median) were associated with improved survival.
  • Moderate to severe myocardial necrosis or fibrosis significantly predicted poorer outcomes (HR 7.17).

Conclusions:

  • Transplant-free survival in GCM is approximately 42% at 5 years.
  • Biomarkers of myocyte injury (troponin-T) and cardiac dysfunction (NT-proBNP, LVEF) are valuable prognostic indicators.
  • Histological evidence of myocardial damage severity is a strong predictor of outcomes in GCM.
Abstract

Keywords:
Inflammatory cardiomyopathyMyocardial biopsyTransplantation

More Related Videos

Myocardial Infarction and Functional Outcome Assessment in Pigs12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

28.8K
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

9.2K

Related Concept Videos

Myocarditis I: Introduction01:21

Myocarditis I: Introduction

Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
548
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
427
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
340
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
627
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
725
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
309