Key result
Among patients with prior acute myocarditis and normal ejection fraction, 49% developed heart failure symptoms over 72 months, associated with an increased E/E' septal ratio (10.9 vs 6.8; P=0.001).
Cohort (n=50)
Absolute Event Rate: 10.9% vs 6.8%
p-value: p=0.001
Patients recovering from acute myocarditis who are discharged with normal LV function remain at significant risk for developing symptomatic diastolic dysfunction (HFpEF) in the long term.
Patients merit long-term HFpEF surveillance after myocarditis with preserved EF; hypothesis-generating for E/E' ratio as predictor.
Background: The aim of this study was to analyse the long-termprognosis of patients with acute myocarditis (AMC), who had been discharged fromthe hospital while having normal left ventricular (LV) function. Methods and Results: We prospectivelystudied 50 patients with acute myocarditis, which underwent endomyocardialbiopsies (EMBs). We examined their clinical condition in a mean follow-up period of 72 (54-78) months, includingtissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilatedcardiomyopathy. 45/ 50 (90%) showed a normal or improvement of LV function over time. In the course of the follow-up,49% (22/45) suffered from heart failure symptoms despite normal ejectionfraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired decelerationtime of early mitral flow velocity (DT) and isovolumic relaxationtime (IVRT) and a pathological increase in the LV filling index E/E , incontrast to patients without heart failure symptoms (E/E septal 10.9 (9.3-13.8) vs. 6.8(6.4-9.1); P 0.001). The plasmaNT-proBNP levels were increased 3-fold inpatients with .9) pmol/L; P 0.006). Conclusions: We assume that the evidence of AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after later years.
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A 2011 study conducted a cohort in Acute myocarditis (n=50). Heart failure symptoms despite normal ejection fraction (HFNEF) vs. No heart failure symptoms was evaluated on LV filling index E/E' septal (p=0.001). Among patients with prior acute myocarditis and normal ejection fraction, 49% developed heart failure symptoms over 72 months, associated with an increased E/E' septal ratio (10.9 vs 6.8; P=0.001).
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