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Clinical Characteristics and Outcomes of Acute Myocarditis: An Analysis of Korean Multicenter Registry

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Author(s)
Junho HyunDayoung PackMinjung BakHyukjin ParkHyung Yoon KimSeonhwa LeeIn-Cheol KimSo Ree KimMi-Na KimKyung-Hee KimSang Eun LeeJeong Hoon Yang
Keimyung Author(s)
Lee, Seon hwaKim, In Cheol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circ J
Issued Date
2024
Volume
55
Issue
5
Keyword
MyocarditisDiagnosisPrognosis
Abstract
Background and Objectives:
Data are limited on the clinical manifestations and outcomes of acute myocarditis from a large-scale registry. We investigated acute myocarditis's clinical characteristics and prognosis from a large-scale, multi-center registry in the Republic of Korea.

Methods:
We collected data from seven hospitals between 2001 and 2021. Clinical variables and outcomes during the index hospitalization and follow-up periods were analyzed. We also evaluated inter-center and temporal differences in diagnostic and treatment patterns.

Results:
Eight hundred forty-one patients diagnosed with acute myocarditis were included. Common symptoms included chest pain (60.4%), followed by fever or myalgia (46.3%), and dyspnea (45.7%). Fulminant myocarditis occurred in 421 (50.1%), with 217 requiring extracorporeal membrane oxygenation (ECMO) support. Endomyocardial biopsy (EMB) was performed in 276 (32.8%) patients, and biopsy-proven diagnosis was made in 234 (27.8%). Based on the EMB results, lymphocytic myocarditis was the predominant form (69.6%), followed by eosinophilic (13.8%) and giant cell myocarditis (1.4%). Eighty-three in-hospital (9.9%) and 16 (1.9%) additional mortality during the follow-up occurred. An increase in the use of EMB, cardiac imaging, and immunosuppressive therapy was noted over time, but in-hospital mortality remained unchanged. Remarkable variations in diagnosis and treatment were observed across different centers.

Conclusions:
This study unveiled clinical features of acute myocarditis in the Republic of Korea, including a high incidence of fulminant myocarditis and complex cases requiring ECMO. Given the considerable inter-center variation in diagnostic and treatment patterns and prognosis, protocolized future trials are needed to clarify diagnosis and treatment in patients with acute myocarditis.
Keimyung Author(s)(Kor)
이선화
김인철
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1738-5555
Source
https://e-kcj.org/DOIx.php?id=10.4070/kcj.2024.0229
DOI
10.4070/kcj.2024.0229
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/46029
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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