Abstract 15015: Clinical Outcome of Acute Viral or Idiopathic Myopericarditis
Aim of the present study is to evaluate the clinical outcome of patients with myopericarditis confirmed by cardiac magnetic resonance (CMR). Methods. From January 2007 to December 2010 all consecutive cases with myopericarditis (diagnostic criteria for acute pericarditis satisfied plus troponin I elevation and evidence of myocardial involvement by CMR) were evaluated in a prospective cohort study and compared with cases with simple acute pericarditis. Etiology may have impact on clinical outcomes, thus only cases with a viral or idiopathic etiology were included, excluding post-cardiac injury syndrome, autoimmune, bacterial and neoplastic etiologies. In-hospital and out-of-hospital complications were assessed including all cause mortality, recurrences, cardiac tamponade, constrictive pericarditis, and admissions related to the myopericardial syndrome. Results. Overall 127 consecutive cases with acute myopericarditis and acute pericarditis (mean age 39 ± 13 years, 84 males) were included in the study. Fifty-three patients (42%; mean age 36 ± 13 years, 41 males, mean troponin I levels 11.5 ± 4 ng/ml ) had a diagnosis of acute myopericarditis. Patients with myopericarditis were younger (respectively 36 ± 13 years vs. 41 ± 13 years;p=0.035), more commonly males (respectively 77 vs. 58%;p= 0.042), had less frequently a pericardial effusion (21 vs. 66%;p<0.001) and lower levels of hs C-reactive protein (4.2 ± 2.4 vs. 8.3 ± 6.1;p<0.001), but similar left ventricular ejection fraction-EF (respectively 58 ± 9 vs. 60 ± 3 %;p=0.08) and in-hospital complications. After a mean follow-up of 33 months, no deaths were recorded in both groups. Patients with simple acute pericarditis had a higher rate of recurrences (respectively 6 vs. 44%;p<0.001) and a worse event free survival (Log rank Mantel-Cox p<0.001). In multivariable analysis, troponin elevation was not associated with an increased risk of complications. Conclusions. Patients with acute viral or idiopathic myopericarditis are younger and more frequently males. Despite troponin elevation and evidence of myocardial involvement on CMR, the overall prognosis is good without a significant risk of death, progression to worsening LV dysfunction or more recurrences.
- © 2012 by American Heart Association, Inc.