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Echocardiographic findings in fulminant and acute myocarditis.

Publication ,  Journal Article
Felker, GM; Boehmer, JP; Hruban, RH; Hutchins, GM; Kasper, EK; Baughman, KL; Hare, JM
Published in: J Am Coll Cardiol
July 2000

OBJECTIVES: We sought to use echocardiography to assess the presentation and potential for recovery of left ventricular (LV) function of patients with fulminant myocarditis compared with those with acute myocarditis. BACKGROUND: The clinical course of patients with myocarditis remains poorly defined. We have previously proposed a classification that provides prognostic information in myocarditis patients. Fulminant myocarditis causes a distinct onset of illness and severe hemodynamic compromise, whereas acute myocarditis has an indistinct presentation, less severe hemodynamic compromise and a greater likelihood of progression to dilated cardiomyopathy. METHODS: Echocardiography was performed at presentation and at six months to test the hypothesis that fulminant (n = 11) or acute (n = 43) myocarditis could be distinguished morphologically. RESULTS: Patients with both fulminant (fractional shortening 19 +/- 4%) and acute myocarditis (17 +/- 7%) had LV systolic dysfunction. Patients with fulminant myocarditis had near normal LV diastolic dimensions (5.3 +/- 0.9 cm) but increased septal thickness (1.2 +/- 0.2 cm) at presentation, while those with acute myocarditis had increased diastolic dimensions (6.1 +/- 0.8 cm, p < 0.01 vs. fulminant) but normal septal thickness (1.0 +/- 0.1 cm, p = 0.01 vs. fulminant). At six months, patients with fulminant myocarditis had dramatic improvement in fractional shortening (30 +/- 8%) compared with no improvement in patients with acute myocarditis (19 +/- 7%, p < 0.01 for interaction between time and type of myocarditis). CONCLUSIONS: Fulminant myocarditis is distinguishable from acute myocarditis by echocardiography. Patients with fulminant myocarditis exhibit a substantial improvement in ventricular function at six months compared with those with acute myocarditis. Echocardiography has value in classifying patients with myocarditis and may provide prognostic information.

Duke Scholars

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Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

July 2000

Volume

36

Issue

1

Start / End Page

227 / 232

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Pulmonary Wedge Pressure
  • Prognosis
  • Myocarditis
  • Myocardial Contraction
  • Humans
  • Heart Rate
  • Echocardiography
  • Disease Progression
  • Cardiovascular System & Hematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Felker, G. M., Boehmer, J. P., Hruban, R. H., Hutchins, G. M., Kasper, E. K., Baughman, K. L., & Hare, J. M. (2000). Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol, 36(1), 227–232. https://doi.org/10.1016/s0735-1097(00)00690-2
Felker, G. M., J. P. Boehmer, R. H. Hruban, G. M. Hutchins, E. K. Kasper, K. L. Baughman, and J. M. Hare. “Echocardiographic findings in fulminant and acute myocarditis.J Am Coll Cardiol 36, no. 1 (July 2000): 227–32. https://doi.org/10.1016/s0735-1097(00)00690-2.
Felker GM, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Baughman KL, et al. Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol. 2000 Jul;36(1):227–32.
Felker, G. M., et al. “Echocardiographic findings in fulminant and acute myocarditis.J Am Coll Cardiol, vol. 36, no. 1, July 2000, pp. 227–32. Pubmed, doi:10.1016/s0735-1097(00)00690-2.
Felker GM, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Baughman KL, Hare JM. Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol. 2000 Jul;36(1):227–232.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

July 2000

Volume

36

Issue

1

Start / End Page

227 / 232

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Pulmonary Wedge Pressure
  • Prognosis
  • Myocarditis
  • Myocardial Contraction
  • Humans
  • Heart Rate
  • Echocardiography
  • Disease Progression
  • Cardiovascular System & Hematology