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Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry "MYKKE".
Schubert, Stephan; Opgen-Rhein, Bernd; Boehne, Martin; Weigelt, Annika; Wagner, Robert; Müller, Götz; Rentzsch, Axel; Zu Knyphausen, Edzard; Fischer, Marcus; Papakostas, Konstantin; Wiegand, Gesa; Ruf, Bettina; Hannes, Tobias; Reineker, Katja; Kiski, Daniela; Khalil, Markus; Steinmetz, Michael; Fischer, Gunther; Pickardt, Thomas; Klingel, Karin; Messroghli, Daniel R; Degener, Franziska.
Afiliación
  • Schubert S; Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany.
  • Opgen-Rhein B; DZHK (German Centre for Cardiovascular Research), Berlin, Germany.
  • Boehne M; Department for Pediatric Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
  • Weigelt A; Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
  • Wagner R; Department for Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany.
  • Müller G; Department for Pediatric Cardiology, Herzzentrum Leipzig, Leipzig, Germany.
  • Rentzsch A; Department for Pediatric Cardiology, Universitäres Herzzentrum Hamburg, Hamburg, Germany.
  • Zu Knyphausen E; Department for Pediatric Cardiology, Universitätsklinikum des Saarlandes, Homburg, Germany.
  • Fischer M; Department for Pediatric Cardiology, Herz- und Diabetes-zentrum NRW, Bad Oeynhausen, Germany.
  • Papakostas K; Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig Maximilians University of Munich, Munich, Germany.
  • Wiegand G; Department for Pediatric Cardiology, Klinikum Links der Weser, Bremen, Germany.
  • Ruf B; Department for Pediatric Cardiology, University Hospital Tübingen, Tübingen, Germany.
  • Hannes T; Department for Pediatric Cardiology, Deutsches Herzzentrum München, München, Germany.
  • Reineker K; Department for Pediatric Cardiology, University Hospital Köln, Köln, Germany.
  • Kiski D; Department for Pediatric Cardiology, Universitäts-Herzzentrum Freiburg Bad Krozingen, Freiburg, Germany.
  • Khalil M; Department for Pediatric Cardiology, University Hospital Münster, Münster, Germany.
  • Steinmetz M; Department for Pediatric Cardiology, University Hospital Gießen, Giessen, Germany.
  • Fischer G; Department for Pediatric Cardiology, Universitätsmedizin Göttingen, Göttingen, Germany.
  • Pickardt T; Department for Pediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Germany.
  • Klingel K; Kompetenznetz Angeborene Herzfehler, Berlin, Germany.
  • Messroghli DR; Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany.
  • Degener F; DZHK (German Centre for Cardiovascular Research), Berlin, Germany.
Pediatr Transplant ; 23(7): e13548, 2019 11.
Article en En | MEDLINE | ID: mdl-31297930
Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty-eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0-2 years) than in the older groups (P < 0.001; 2-12 and 13-18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death (P < 0.001). Myocarditis represents a life-threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life-saving therapeutic option in children with myocarditis with a weaning rate of 43%.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Trasplante de Corazón / Insuficiencia Cardíaca / Miocarditis Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2019 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Dinamarca
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Trasplante de Corazón / Insuficiencia Cardíaca / Miocarditis Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatr Transplant Asunto de la revista: PEDIATRIA / TRANSPLANTE Año: 2019 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Dinamarca