Related Experiment Video
Updated: Aug 14, 2025
Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
Published on: June 20, 2014
Exercise testing in patients with multisystem inflammatory syndrome in children-related myocarditis versus idiopathic
Daniel Ziebell1, Trisha Patel1, Megan Stark2
1Emory University, Atlanta, GA, USA.
Insights
Children with multisystem inflammatory syndrome (MIS-C) and viral myocarditis show similar, normal exercise capacity 3-6 months post-discharge. However, lower ejection fraction during hospitalization correlated with reduced peak VO2 in viral myocarditis patients.
Area of Science:
- Pediatric Cardiology
- Pediatric Critical Care Medicine
- Exercise Physiology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) typically shows rapid cardiac recovery.
- Long-term exercise capacity outcomes in MIS-C patients remain largely unknown.
- Comparison with viral/idiopathic myocarditis is needed to understand MIS-C's impact on exercise capacity.
Purpose of the Study:
- To compare exercise capacity in children diagnosed with MIS-C versus viral/idiopathic myocarditis.
- To assess outcomes at 3-6 months after initial diagnosis.
- To identify potential correlations between cardiac function and exercise capacity.
Main Methods:
- Retrospective cohort study design.
- Inclusion of patients diagnosed with MIS-C or viral/idiopathic myocarditis.
- Cardiopulmonary exercise testing (CPET) data analyzed within 3-6 months post-discharge, ensuring maximal effort (RER >1.10).
- Echocardiographic and laboratory data were also obtained.
Main Results:
- Thirty-one MIS-C patients and 25 viral/idiopathic myocarditis patients were analyzed.
- No significant differences in key exercise parameters (peak VO2, maximal heart rate, METs, anaerobic threshold, O2 pulse) were observed between groups.
- A significant correlation between lower ejection fraction and reduced peak VO2 was found in viral/idiopathic myocarditis, but not in MIS-C patients.
Conclusions:
- Children with MIS-C and viral myocarditis generally exhibit normal exercise capacity 3-6 months post-hospitalization.
- While overall exercise capacity is comparable, cardiac function during hospitalization may predict exercise outcomes in viral/idiopathic myocarditis.
- Further research may elucidate long-term functional recovery in MIS-C survivors.
Background:
While most children with multisystem inflammatory syndrome in children have rapid recovery of cardiac dysfunction, little is known about the long-term outcomes regarding exercise capacity. We aimed to compare the exercise capacity among patients with multisystem inflammatory syndrome in children versus viral/idiopathic myocarditis at 3-6 months after initial diagnosis.
Methods:
We performed a retrospective cohort study among patients with multisystem inflammatory syndrome in children in June 2020 to May 2021 and patients with viral/idiopathic myocarditis in August 2014 to January 2020. Data from cardiopulmonary exercise test as well as echocardiographic and laboratory data were obtained. Inclusion criteria included diagnosis of multisystem inflammatory syndrome in children or viral/idiopathic myocarditis, exercise test performed within 3-6 months of hospital discharge, and maximal effort on cardiopulmonary exercise test as determined by respiratory exchange ratio >1.10.
Results:
Thirty-one patients with multisystem inflammatory syndrome in children and 25 with viral/idiopathic myocarditis were included. The mean percent predicted peak VO2 was 90.84% for multisystem inflammatory syndrome in children patients and 91.08% for those with viral/idiopathic myocarditis (p-value 0.955). There were no statistically significant differences between the groups with regard to percent predicted maximal heart rate, metabolic equivalents, percent predicted peak VO2, percent predicted anerobic threshold, or percent predicted O2 pulse. There was a statistically significant correlation between lowest ejection fraction during hospitalisation and peak VO2 among viral/idiopathic myocarditis patients (r: 0.62, p-value 0.01) but not multisystem inflammatory syndrome in children patients (r: 0.1, p-value 0.6).
Conclusions:
Patients with multisystem inflammatory syndrome in children and viral myocarditis appear to, on average, have normal exercise capacity around 3-6 months following hospital discharge. For patients with viral/idiopathic myocarditis, those with worse ejection fraction during hospitalisation had lower peak VO2 on cardiopulmonary exercise test.
More Related Videos
07:40Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
Published on: October 10, 2019
05:58Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
Related Concept Videos
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:14Myocarditis III: Medical Management
01:22Myocarditis IV: Nursing Management
01:21Myocarditis I: Introduction
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:19Pericarditis II: Clinical Features and Diagnostic Tests