Key result
Fulminant viral myocarditis in children was associated with higher mortality (32% vs 7.5%) but a lower risk of developing dilated cardiomyopathy (4% vs 25%) compared to acute viral myocarditis.
Why the study?
Do cardiac troponin levels correlate with cardiac dysfunction and predict outcomes in children with acute and fulminant viral myocarditis?
Observational (n=65)
Do cardiac troponin levels correlate with cardiac dysfunction and predict outcomes in children with acute and fulminant viral myocarditis?
In children with viral myocarditis, cardiac troponin levels correlate with the severity of cardiac dysfunction and can predict short-term prognosis, with fulminant cases showing higher troponins but a lower risk of progressing to dilated cardiomyopathy compared to acute cases.
Answers are grounded in this paper and cite their sources.
Anticipate higher mortality in pediatric fulminant myocarditis; observational data leave open differential long-term cardiomyopathy surveillance needs.
OBJECTIVES: To study the correlation between cardiac troponins blood levels and degrees of cardiac dysfunction in children with acute and fulminant viral myocarditis and to study their prognostic role in predicting the outcomes and risk of having dilated cardiomyopathy. METHODOLOGY: Troponin I & T blood levels were measured in 65 children with acute or fulminant viral myocarditis. The cardiac functions of RV & LV were assessed by Doppler echocardiography. RESULTS: The levels of cTnI & CTnT were significantly higher in patients with fulminant myocarditis than in controls and children with acute myocarditis (p < 0.05 & <0.001* respectively). The cardiac functions were significantly impaired in fulminant myocarditis than in acute myocarditis (p < 0.001*). There were negative correlations between the cardiac troponins levels and the cardiac functions measured by echocardiography in children with acute and fulminant myocarditis. There were 3 deaths (7.5%), and 10 (25%) children developed dilated cardiomyopathy in acute myocarditis while there were eight deaths (32%) and one patient (4%) who developed dilated cardiomyopathy in fulminant myocarditis group. CONCLUSION: Cardiac troponins levels can predict the severity of myocarditis and the prognosis on the short-term level. Fulminant myocarditis was associated with higher levels of both cTn I & cTn T than acute myocarditis. Despite that fulminant myocarditis has a more aggressive course, the risk of developing cardiomyopathy was less than in acute myocarditis.
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Al‐Beltagi et al. (2010) conducted an observational in acute and fulminant viral myocarditis (n=65). Fulminant viral myocarditis vs. Acute viral myocarditis was evaluated on death. Fulminant viral myocarditis in children was associated with higher mortality (32% vs 7.5%) but a lower risk of developing dilated cardiomyopathy (4% vs 25%) compared to acute viral myocarditis.
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