Characteristics of Patients With Advanced Heart Failure Having Eosinophilic Infiltration of the Myocardium in the Recent Era
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Key result
Hypersensitivity myocarditis was found in 2.8% of explanted hearts, often associated with dobutamine use, but did not significantly affect post-transplant survival compared to other causes of heart failure.
Why the study?
Does the presence of hypersensitivity myocarditis (HSM) affect post-transplant survival in patients undergoing heart transplantation for advanced heart failure?
Population
761 consecutive patients undergoing de novo heart transplantation for advanced heart failure at a single…
Comparison
Presence of hypersensitivity myocarditis with… vs Patients transplanted for active myocarditis or…
Design
Cohort
Authors
Discussion
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Implication
Incidental HSM should not alter post-transplant management; leaves open dobutamine's causal role in advanced HF.
Study Design
Type
Observational (n=761)
Multicenter
No
Structured PICO
Does the presence of hypersensitivity myocarditis (HSM) affect post-transplant survival in patients undergoing heart transplantation for advanced heart failure?
P
Population
761 consecutive patients with advanced heart failure undergoing de novo heart transplantation at a single US center.
E
Exposure
Presence of hypersensitivity myocarditis (HSM) with eosinophilic infiltration in the explanted heart (exposure group)
C
Comparator
Patients transplanted for active myocarditis (n=31) or other causes of heart failure (n=709) (non-exposure groups)
O
Outcome
Post-transplant survival rateshard clinical
Incidental finding of hypersensitivity myocarditis in explanted hearts of advanced heart failure patients is associated with multiple pre-transplant medications (especially dobutamine) but does not adversely affect post-transplant survival.
Limitations
- Retrospective, single center analysis
- Small number of patients with hypersensitivity myocarditis
- None of the patients were diagnosed with HSM during the transplant evaluation process
- Difficult to distinguish HSM from myocarditis associated with hypereosinophilic syndrome
- Multiple drug therapy makes it difficult to determine which specific drug caused HSM
- retrospective, single center analysis
- small number of patients with HSM
- none of the patients were diagnosed as HSM during the transplant evaluation process
- difficult to distinguish HSM from myocarditis associated with hypereosinophilic syndrome
Cite This Study
Yoshizawa et al. (2013) conducted an observational in Advanced heart failure (n=761). Hypersensitivity myocarditis (eosinophilic infiltration) vs. Active myocarditis or other causes of heart failure was evaluated on Post-transplant survival. Hypersensitivity myocarditis was found in 2.8% of explanted hearts, often associated with dobutamine use, but did not significantly affect post-transplant survival compared to other causes of heart failure.
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