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Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
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Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse

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Characteristics of Clinically Diagnosed Pediatric Myocarditis in a Contemporary Multi-Center Cohort

Ryan J Butts1,2, Gerard J Boyle3, Shriprasad R Deshpande4

  • 1Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA. ryan.butts@utsouthwestern.edu.

Pediatric Cardiology
|May 25, 2017
PubMed

Insights

This study on pediatric myocarditis found a bimodal age distribution. Gastrointestinal symptoms and reduced echo shortening fraction may predict severe outcomes in hospitalized children.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Inflammatory Heart Disease

Background:

  • Myocarditis is an inflammatory condition affecting the heart muscle in children.
  • Accurate diagnosis and risk stratification are crucial for managing pediatric myocarditis.
  • Understanding contemporary trends in pediatric myocarditis is essential for clinical practice.

Purpose of the Study:

  • To describe a current cohort of pediatric patients hospitalized with suspected myocarditis.
  • To identify factors associated with adverse outcomes, including mortality and heart transplantation.
  • To evaluate the effectiveness of immunotherapy in pediatric myocarditis.

Main Methods:

  • Retrospective chart review of 171 pediatric patients (≤18 years) with suspected myocarditis across seven tertiary hospitals (2008-2012).
  • Exclusion criteria included lack of suspected myocarditis or an alternative diagnosis.
  • Analysis of demographic data, clinical presentation, treatment, and outcomes, including mortality, transplantation, and readmission.

Main Results:

  • Pediatric myocarditis exhibited a bimodal age distribution (24% <2 years, 46% aged 13-18 years).
  • No significant difference in mortality, heart transplantation, or readmission was observed between immunotherapy groups (IVIG, steroids, both, or none).
  • Gastrointestinal symptoms and lower echocardiographic shortening fraction at admission were associated with increased risk of death or transplantation.

Conclusions:

  • Pediatric myocarditis presents with a bimodal age distribution.
  • Current immunotherapy regimens (IVIG, steroids) do not appear to influence mortality or transplantation rates.
  • Gastrointestinal symptoms and reduced echocardiographic shortening fraction are potential indicators for identifying high-risk pediatric patients with myocarditis.

Keywords:
MyocarditisOutcomesPediatrics

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