Development of diastolic heart failure in a 6-year follow-up study in patients after acute myocarditis
BackgroundThe aim of this study was to analyse the long-term prognosis of patients with acute myocarditis (AMC) who had been discharged from hospital while having normal left ventricular (LV) function.Methods and results50 patients with acute myocarditis who underwent endomyocardial biopsies (EMBs)...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2011-05, Vol.97 (9), p.709-714 |
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| creator | Escher, Felicitas Westermann, Dirk Gaub, Regina Pronk, Johannes Bock, Thomas Al-Saadi, Nidal Kühl, Uwe Schultheiss, Heinz-Peter Tschöpe, Carsten |
| description | BackgroundThe aim of this study was to analyse the long-term prognosis of patients with acute myocarditis (AMC) who had been discharged from hospital while having normal left ventricular (LV) function.Methods and results50 patients with acute myocarditis who underwent endomyocardial biopsies (EMBs) were prospectively studied. Their clinical condition was examined during a mean follow-up period of 72 (54–78) months, including tissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilated cardiomyopathy. 45/50 (90%) showed a normal or improvement in LV function over time. In the course of the follow-up, 49% (22/45) suffered from heart failure symptoms despite a normal ejection fraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired deceleration time of early mitral flow velocity and isovolumic relaxation time, and a pathological increase in the LV filling index E/E′, in contrast 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). Plasma N-terminal proB-type natriuretic peptide levels were increased threefold in patients with HFNEF (19.9 (10.6–24.1) vs 7.3 (4.2–11.9) pmol/l; p=0.006).ConclusionsIt is assumed that the evidence for AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after several years. |
| doi_str_mv | 10.1136/hrt.2010.199489 |
| format | Article |
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Their clinical condition was examined during a mean follow-up period of 72 (54–78) months, including tissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilated cardiomyopathy. 45/50 (90%) showed a normal or improvement in LV function over time. In the course of the follow-up, 49% (22/45) suffered from heart failure symptoms despite a normal ejection fraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired deceleration time of early mitral flow velocity and isovolumic relaxation time, and a pathological increase in the LV filling index E/E′, in contrast 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). Plasma N-terminal proB-type natriuretic peptide levels were increased threefold in patients with HFNEF (19.9 (10.6–24.1) vs 7.3 (4.2–11.9) pmol/l; p=0.006).ConclusionsIt is assumed that the evidence for AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after several years.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/hrt.2010.199489</identifier><identifier>PMID: 21134904</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Acute Disease ; Adult ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiomyopathy ; cardiomyopathy dilated ; Cardiovascular disease ; Diastolic dysfunction ; Female ; Flow velocity ; Gangrene ; Genome, Viral ; Heart ; Heart attacks ; Heart failure ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart Failure, Diastolic - etiology ; Heart Failure, Diastolic - physiopathology ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Immunohistochemistry ; Inflammation ; Magnetic Resonance Angiography ; Male ; Medical sciences ; Middle Aged ; Morbidity ; Mortality ; myocarditis ; Myocarditis - complications ; Myocarditis. Cardiomyopathies ; Prospective Studies ; Rodents ; Ventricular Dysfunction, Left - etiology</subject><ispartof>Heart (British Cardiac Society), 2011-05, Vol.97 (9), p.709-714</ispartof><rights>2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2011 (c) 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b534t-5eb23ed9436260a31752e42dd3b1dc1b78a631a630a079d83ac71331039cfab23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/97/9/709.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/97/9/709.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,315,782,786,3200,23580,27933,27934,77610,77641</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24077273$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21134904$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Escher, Felicitas</creatorcontrib><creatorcontrib>Westermann, Dirk</creatorcontrib><creatorcontrib>Gaub, Regina</creatorcontrib><creatorcontrib>Pronk, Johannes</creatorcontrib><creatorcontrib>Bock, Thomas</creatorcontrib><creatorcontrib>Al-Saadi, Nidal</creatorcontrib><creatorcontrib>Kühl, Uwe</creatorcontrib><creatorcontrib>Schultheiss, Heinz-Peter</creatorcontrib><creatorcontrib>Tschöpe, Carsten</creatorcontrib><title>Development of diastolic heart failure in a 6-year follow-up study in patients after acute myocarditis</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>BackgroundThe aim of this study was to analyse the long-term prognosis of patients with acute myocarditis (AMC) who had been discharged from hospital while having normal left ventricular (LV) function.Methods and results50 patients with acute myocarditis who underwent endomyocardial biopsies (EMBs) were prospectively studied. Their clinical condition was examined during a mean follow-up period of 72 (54–78) months, including tissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilated cardiomyopathy. 45/50 (90%) showed a normal or improvement in LV function over time. In the course of the follow-up, 49% (22/45) suffered from heart failure symptoms despite a normal ejection fraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired deceleration time of early mitral flow velocity and isovolumic relaxation time, and a pathological increase in the LV filling index E/E′, in contrast 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). Plasma N-terminal proB-type natriuretic peptide levels were increased threefold in patients with HFNEF (19.9 (10.6–24.1) vs 7.3 (4.2–11.9) pmol/l; p=0.006).ConclusionsIt is assumed that the evidence for AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after several years.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomyopathy</subject><subject>cardiomyopathy dilated</subject><subject>Cardiovascular disease</subject><subject>Diastolic dysfunction</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Gangrene</subject><subject>Genome, Viral</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart Failure, Diastolic - etiology</subject><subject>Heart Failure, Diastolic - physiopathology</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Inflammation</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>myocarditis</subject><subject>Myocarditis - complications</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Prospective Studies</subject><subject>Rodents</subject><subject>Ventricular Dysfunction, Left - etiology</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc2L1TAUxYsozoeu3UlAZEDoTL6apEt96lMYdDEq7sJtmjB5tk1NUvX99-bR5whuXITk3vs7h0tOVT0h-JIQJq5uY76k-FC1LVftveqUcKHq0vp6v7xZ09QCM3lSnaW0wxjzVomH1QktYt5iflq51_aHHcI82imj4FDvIeUweINuLcSMHPhhiRb5CQES9b40kQvDEH7Wy4xSXvr9YTZD9sUhIXDZRgRmyRaN-2Ag9j779Kh64GBI9vHxPq8-v33zafOuvv64fb95eV13DeO5bmxHme1bzgQVGBiRDbWc9j3rSG9IJxUIRsrBgGXbKwZGEsYIZq1xULTn1cXqO8fwfbEp69EnY4cBJhuWpJUgFCtOeSGf_UPuwhKnspwmUmFJhOKiUFcrZWJIKVqn5-hHiHtNsD4koEsC-pCAXhMoiqdH36UbbX_H__nyAjw_ApAMDC7CZHz6y3EsJZWscPXK-ZTtr7s5xG9aSCYb_eHLRm_xzQ1V21daFf7Fynfj7r9b_gbvcqn_</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>Escher, Felicitas</creator><creator>Westermann, Dirk</creator><creator>Gaub, Regina</creator><creator>Pronk, Johannes</creator><creator>Bock, Thomas</creator><creator>Al-Saadi, Nidal</creator><creator>Kühl, Uwe</creator><creator>Schultheiss, Heinz-Peter</creator><creator>Tschöpe, Carsten</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20110501</creationdate><title>Development of diastolic heart failure in a 6-year follow-up study in patients after acute myocarditis</title><author>Escher, Felicitas ; Westermann, Dirk ; Gaub, Regina ; Pronk, Johannes ; Bock, Thomas ; Al-Saadi, Nidal ; Kühl, Uwe ; Schultheiss, Heinz-Peter ; Tschöpe, Carsten</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b534t-5eb23ed9436260a31752e42dd3b1dc1b78a631a630a079d83ac71331039cfab23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiomyopathy</topic><topic>cardiomyopathy dilated</topic><topic>Cardiovascular disease</topic><topic>Diastolic dysfunction</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Gangrene</topic><topic>Genome, Viral</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart Failure, Diastolic - etiology</topic><topic>Heart Failure, Diastolic - physiopathology</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Inflammation</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>myocarditis</topic><topic>Myocarditis - complications</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Prospective Studies</topic><topic>Rodents</topic><topic>Ventricular Dysfunction, Left - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Escher, Felicitas</creatorcontrib><creatorcontrib>Westermann, Dirk</creatorcontrib><creatorcontrib>Gaub, Regina</creatorcontrib><creatorcontrib>Pronk, Johannes</creatorcontrib><creatorcontrib>Bock, Thomas</creatorcontrib><creatorcontrib>Al-Saadi, Nidal</creatorcontrib><creatorcontrib>Kühl, Uwe</creatorcontrib><creatorcontrib>Schultheiss, Heinz-Peter</creatorcontrib><creatorcontrib>Tschöpe, Carsten</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Escher, Felicitas</au><au>Westermann, Dirk</au><au>Gaub, Regina</au><au>Pronk, Johannes</au><au>Bock, Thomas</au><au>Al-Saadi, Nidal</au><au>Kühl, Uwe</au><au>Schultheiss, Heinz-Peter</au><au>Tschöpe, Carsten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of diastolic heart failure in a 6-year follow-up study in patients after acute myocarditis</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>97</volume><issue>9</issue><spage>709</spage><epage>714</epage><pages>709-714</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>BackgroundThe aim of this study was to analyse the long-term prognosis of patients with acute myocarditis (AMC) who had been discharged from hospital while having normal left ventricular (LV) function.Methods and results50 patients with acute myocarditis who underwent endomyocardial biopsies (EMBs) were prospectively studied. Their clinical condition was examined during a mean follow-up period of 72 (54–78) months, including tissue Doppler imaging (TDI). 4% (2/50) died, and 6% (3/50) developed dilated cardiomyopathy. 45/50 (90%) showed a normal or improvement in LV function over time. In the course of the follow-up, 49% (22/45) suffered from heart failure symptoms despite a normal ejection fraction (HFNEF). This was associated with an abnormal E/A ratio, an impaired deceleration time of early mitral flow velocity and isovolumic relaxation time, and a pathological increase in the LV filling index E/E′, in contrast 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). Plasma N-terminal proB-type natriuretic peptide levels were increased threefold in patients with HFNEF (19.9 (10.6–24.1) vs 7.3 (4.2–11.9) pmol/l; p=0.006).ConclusionsIt is assumed that the evidence for AMC is associated not only with the risk of developing LV dilatation but also with an increased risk of symptomatic diastolic dysfunction after several years.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>21134904</pmid><doi>10.1136/hrt.2010.199489</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Adult Biological and medical sciences Cardiology Cardiology. Vascular system Cardiomyopathy cardiomyopathy dilated Cardiovascular disease Diastolic dysfunction Female Flow velocity Gangrene Genome, Viral Heart Heart attacks Heart failure Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Failure, Diastolic - etiology Heart Failure, Diastolic - physiopathology Hospitalization - statistics & numerical data Hospitals Humans Immunohistochemistry Inflammation Magnetic Resonance Angiography Male Medical sciences Middle Aged Morbidity Mortality myocarditis Myocarditis - complications Myocarditis. Cardiomyopathies Prospective Studies Rodents Ventricular Dysfunction, Left - etiology |
| title | Development of diastolic heart failure in a 6-year follow-up study in patients after acute myocarditis |
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