Clinical Characteristics and Outcomes of Acute Myocarditis: An Analysis of Korean Multicenter Registry
- Author(s)
- Junho Hyun; Dayoung Pack; Minjung Bak; Hyukjin Park; Hyung Yoon Kim; Seonhwa Lee; In-Cheol Kim; So Ree Kim; Mi-Na Kim; Kyung-Hee Kim; Sang Eun Lee; Jeong Hoon Yang
- Keimyung Author(s)
- Lee, Seon hwa; Kim, In Cheol
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Korean Circ J
- Issued Date
- 2024
- Volume
- 55
- Issue
- 5
- Keyword
- Myocarditis; Diagnosis; Prognosis
- 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.
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