Echocardiographic findings in fulminant and acute myocarditis

G. Michael Felker, John P. Boehmer, Ralph H. Hruban, Grover M. Hutchins, Edward K. Kasper, Kenneth L. Baughman, Joshua Hare

Research output: Contribution to journalArticle

227 Citations (Scopus)

Abstract

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. (C) 2000 by the American College of Cardiology.

Original languageEnglish
Pages (from-to)227-232
Number of pages6
JournalJournal of the American College of Cardiology
Volume36
Issue number1
DOIs
StatePublished - Jul 1 2000
Externally publishedYes

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Myocarditis
Echocardiography
Hemodynamics
Ventricular Function
Dilated Cardiomyopathy
Left Ventricular Dysfunction

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Felker, G. M., Boehmer, J. P., Hruban, R. H., Hutchins, G. M., Kasper, E. K., Baughman, K. L., & Hare, J. (2000). Echocardiographic findings in fulminant and acute myocarditis. Journal of the American College of Cardiology, 36(1), 227-232. https://doi.org/10.1016/S0735-1097(00)00690-2

Echocardiographic findings in fulminant and acute myocarditis. / Felker, G. Michael; Boehmer, John P.; Hruban, Ralph H.; Hutchins, Grover M.; Kasper, Edward K.; Baughman, Kenneth L.; Hare, Joshua.

In: Journal of the American College of Cardiology, Vol. 36, No. 1, 01.07.2000, p. 227-232.

Research output: Contribution to journalArticle

Felker, GM, Boehmer, JP, Hruban, RH, Hutchins, GM, Kasper, EK, Baughman, KL & Hare, J 2000, 'Echocardiographic findings in fulminant and acute myocarditis', Journal of the American College of Cardiology, vol. 36, no. 1, pp. 227-232. 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. Journal of the American College of Cardiology. 2000 Jul 1;36(1):227-232. https://doi.org/10.1016/S0735-1097(00)00690-2
Felker, G. Michael ; Boehmer, John P. ; Hruban, Ralph H. ; Hutchins, Grover M. ; Kasper, Edward K. ; Baughman, Kenneth L. ; Hare, Joshua. / Echocardiographic findings in fulminant and acute myocarditis. In: Journal of the American College of Cardiology. 2000 ; Vol. 36, No. 1. pp. 227-232.
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abstract = "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. (C) 2000 by the American College of Cardiology.",
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AB - 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. (C) 2000 by the American College of Cardiology.

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