Key Points
- To evaluate the efficacy of immunosuppressive therapy with prednisolone administered at three months after the onset of acute viral myocarditis.
- Prospective randomized trial enrolling 68 children (from 173 screened) diagnosed with acute viral myocarditis of 3 months duration via echocardiography and serum viral antibodies.
- Participants were randomized to either a prednisolone-treated group (n=44; follow-up 15.1 ± 9.2 months) or a control group (n=24; follow-up 13.6 ± 10.6 months).
- At 1 month after randomization, significantly more children in the prednisolone group achieved an ejection fraction >40% compared to controls (p = 0.029).
- Categorical improvement in ejection fraction (>10% increase vs. <10% or no change) after 1 month was significantly higher in the prednisolone group (p = 0.019).
- At the conclusion of follow-up, a significantly higher proportion of prednisolone-treated children attained an ejection fraction >60% compared to control subjects (p = 0.049).
Structured PICO
Does prednisolone improve ejection fraction in children with acute viral myocarditis of 3 months duration?
PPopulation68 children with acute viral myocarditis of 3 months duration (diagnosed based on echocardiography and serum viral antibodies)
IInterventionPrednisolone administered at the 3-month duration of acute myocarditis
OOutcomeIncrease in ejection fraction to more than 40% at 1 month after randomizationsurrogate
Immunosuppression with prednisolone administered 3 months after the onset of acute viral myocarditis significantly improves left ventricular ejection fraction in children.