Multisystemic Inflammation Influences Prognosis in Fulminant Lymphocytic Myocarditis

Background: Multisystem inflammatory syndrome (MIS) is a hyperinflammatory shock associated with cardiac dysfunction and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, there are no reports on using MIS criteria, such as multisystemic inflammation (MSI) in fulminant...

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Published in:Circulation Journal 2024/04/25, Vol.88(5), pp.722-731
Main Authors: Kawano, Hiroaki, Ikeda, Satoshi, Kanaoka, Koshiro, Sato, Shuntaro, Eto, Ryo, Ueno, Yuki, Onoue, Kenji, Saito, Yoshihiko, Maemura, Koji, the Japanese Registry of Fulminant Myocarditis Investigators
Format: Article
Language:English
Subjects:
Adult
Aged
Clinical course
COVID-19 - complications
COVID-19 - mortality
Female
Heart Transplantation
Humans
Infection
Inflammation
Lymphocytes - pathology
Male
Middle Aged
Myocarditis
Myocarditis - mortality
Myocarditis - pathology
Prognosis
Retrospective Studies
Risk Factors
SARS-CoV-2
Systemic Inflammatory Response Syndrome - mortality
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Summary:Background: Multisystem inflammatory syndrome (MIS) is a hyperinflammatory shock associated with cardiac dysfunction and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, there are no reports on using MIS criteria, such as multisystemic inflammation (MSI) in fulminant myocarditis, without SARS-CoV-2 infection. This study investigated the differences in clinical characteristics and course between patients with fulminant lymphocytic myocarditis (FLM) plus MSI and those without MSI.Methods and Results: This multicenter retrospective cohort study included 273 patients with FLM registered in the JROAD-DPC database between April 2014 and March 2017. We evaluated the presence of MSI using criteria modified from previously reported MIS criteria and compared the characteristics and risk of mortality or heart transplantation between FLM patients with MSI and without MSI. Of the 273 patients with FLM, 107 (39%) were diagnosed with MSI. The MSI group was younger (44 vs. 57 years; P
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-23-0914