Huang, Florent and Ammirati, Enrico and Ponnaiah, Maharajah and Montero, Santiago and Raimbault, Victor and Abrams, Darryl and Lebreton, Guillaume and Pellegrino, Vincent and Ihle, Joshua and Bottiroli, Maurizio and Persichini, Romain and Barrionuevo-Sanchez, Marisa Isabel and Ariza-Sole, Albert and Ng, Pauline Yeung and Sin, Simon Wai Ching and Ayer, Raj and Buscher, Hergen and Belaid, Slimane and Delmas, Clement and Ferreira, Rita and Albuquerque Jr, Roberto Roncon and Lopez-Sobrino, Teresa and Bunge, Jeroen J. H. and Fisser, Christoph and Franchineau, Guillaume and Mccanny, Jamie and Ohshimo, Shinichiro and Sionis, Alessandro and Hernandez-Perez, Francisco Jose and Barge-Caballero, Eduardo and Balik, Martin and Muglia, Henrique and Park, Sunghoon and Donker, Dirk W. and Porral, Beatriz and Aissaoui, Nadia and Dessap, Armand Mekontso and Burgos, Virginia and Lesouhaitier, Mathieu and Fried, Justin and Jung, Jae-Seung and Rosillo, Sandra and Scherrer, Vincent and Nseir, Saad and Winszewski, Hadrien and Jorge-Perez, Pablo and Kimmoun, Antoine and Diaz, Rodrigo and Combes, Alain and Schmidt, Matthieu and FULLMOON Study Grp, (2023) Fulminant myocarditis proven by early biopsy and outcomes. OXFORD UNIV PRESS, OXFORD.
Full text not available from this repository. (Request a copy)Abstract
Background and Aims While endomyocardial biopsy (EMB) is recommended in adult patients with fulminant myocarditis, the clinical impact of its timing is still unclear.Methods Data were collected from 419 adult patients with clinically suspected fulminant myocarditis admitted to intensive care units across 36 tertiary centres in 15 countries worldwide. The diagnosis of myocarditis was histologically proven in 210 (50%) patients, either by EMB (n = 183, 44%) or by autopsy/explanted heart examination (n = 27, 6%), and clinically suspected cardiac magnetic resonance imaging confirmed in 96 (23%) patients. The primary outcome of survival free of heart transplantation (HTx) or left ventricular assist device (LVAD) at 1 year was specifically compared between patients with early EMB (within 2 days after intensive care unit admission, n = 103) and delayed EMB (n = 80). A propensity score-weighted analysis was done to control for confounders.Results Median age on admission was 40 (29-52) years, and 322 (77%) patients received temporary mechanical circulatory support. A total of 273 (65%) patients survived without HTx/LVAD. The primary outcome was significantly different between patients with early and delayed EMB (70% vs. 49%, P = .004). After propensity score weighting, the early EMB group still significantly differed from the delayed EMB group in terms of survival free of HTx/LVAD (63% vs. 40%, P = .021). Moreover, early EMB was independently associated with a lower rate of death or HTx/LVAD at 1 year (odds ratio of 0.44; 95% confidence interval: 0.22-0.86; P = .016).Conclusions Endomyocardial biopsy should be broadly and promptly used in patients admitted to the intensive care unit for clinically suspected fulminant myocarditis. Structured Graphical Abstract The FULLMOON international cohort of clinically suspected and biopsy-proven fulminant myocarditis. EMB, endomyocardial biopsy; FM, fulminant myocarditis; ICU, intensive care unit; LVAD, left ventricular assist device; t-MCS, temporary mechanical circulatory support.
| Item Type: | Other |
|---|---|
| Uncontrolled Keywords: | GIANT-CELL MYOCARDITIS; EXTRACORPOREAL MEMBRANE-OXYGENATION; IMMUNOSUPPRESSIVE THERAPY; ENDOMYOCARDIAL BIOPSY; CARDIOGENIC-SHOCK; FOLLOW-UP; SUPPORT; MANAGEMENT; DIAGNOSIS; CARDIOMYOPATHY; Fulminant myocarditis; ECMO; Mechanical circulatory support; Outcome; Endomyocardial biopsy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 May 2024 09:07 |
| Last Modified: | 07 May 2024 09:07 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60991 |
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