Document Detail


Low troponin-I levels on admission are associated with worse prognosis in patients with fulminant myocarditis.
MedLine Citation:
PMID:  19715884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The clinical outcomes of patients with fulminant acute myocarditis (FAM) range from death to complete recovery. We sought to identify clinical, biological, and echocardiographic characteristics of prognostic value for this population. METHODS AND RESULTS: We prospectively included 185 patients with the diagnosis of acute myocarditis who were admitted to our institution between 2000 and 2007, selecting 15 who displayed FAM, namely, severe congestive heart failure or cardiogenic shock, requiring inotropic and/or mechanical circulatory support. Their mean age was 27.9 +/- 12.4 years (range, 12-52) and mean left ventricular ejection fraction (LVEF) was 22 +/- 8.4% (range, 10-35). Seven subjects had poor outcomes, defined as death (n = 4), urgent transplantation (x = 2), or persistent left ventricular dysfunction (n = 3). The other 6 individuals experienced complete recovery of ventricular function. Troponin-I values below 1 ng/mL on admission were significantly associated with greater in-hospital (P = .05) and mid-term poor outcomes (P = .001). Additionally, patients with poor outcomes showed significantly lower LVEF (17.6 +/- 6.2% vs 28.8 +/- 6.9%; P = .006). CONCLUSION: Among patients with FAM, normal or minimal elevation of troponin-I and low LVEF on admission were associated with worse in-hospital and mid-term prognosis.
Authors:
X Freixa; A Sionis; A Castel; E Guasch; P Loma-Osorio; D Arzamendi; E Roig; F Perez-Villa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  41     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-31     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2234-6     Citation Subset:  IM    
Affiliation:
Cardiology Department, Thorax Institute, Hospital Clinic of Barcelona, Barcelona, Spain. freixa@clinic.ub.es
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
C-Reactive Protein / metabolism
Child
Female
Heart Failure / blood,  mortality,  surgery
Heart Transplantation / physiology*
Humans
Male
Middle Aged
Myocarditis / blood*,  classification,  surgery
Prognosis
Severity of Illness Index
Shock, Cardiogenic / surgery
Treatment Outcome
Troponin I / blood*
Ventricular Dysfunction, Left / blood,  surgery
Young Adult
Chemical
Reg. No./Substance:
0/Troponin I; 9007-41-4/C-Reactive Protein

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