Predictors of Outcomes in Patients With Clinically Suspected Myocarditis: Analysis From a Single Center Registry

Background: Acute myocarditis is an inflammatory condition of the myocardium that typically follows a benign course, although fulminant cases can be fatal. The clinical trajectory is largely determined by the degree of left ventricular ejection fraction (LVEF) impairment and the presence of associated complications. Although LVEF often recovers within weeks to months after the acute episode, some patients develop persistent dysfunction. This study aimed to identify potential predictors of outcomes following acute myocarditis using data from a single-center registry. Methods: This retrospective study included 157 patients with clinically suspected myocarditis. Demographic, echocardiographic, and laboratory variables, as well as clinical outcome data, including recurrent readmissions and persistent cardiac dysfunction, were collected. Associations between echocardiographic and laboratory parameters and outcomes were analyzed. Results: Approximately 30% of patients had reduced LVEF (LVEF <55%) during the index hospitalization. Among patients with reduced LVEF, 53% exhibited persistent cardiac dysfunction at 4-6 weeks of follow-up. Patients with reduced LVEF had higher troponin and N-terminal pro-B-type natriuretic peptide levels, as well as longer hospital length of stay. Readmission rates for chest pain were comparable between groups. Reduced LVEF during the index hospitalization and diabetes were the strongest independent predictors of persistent cardiac dysfunction. Conclusions: Cardiac dysfunction is common in clinically suspected myocarditis but is not associated with increased readmission rates. Reduced LVEF and diabetes emerged as potential predictors of persistent cardiac dysfunction following the acute episode.