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"

被引：41

作者：

Schubert, Stephan ^{[1
,2
]}

Opgen-Rhein, Bernd ^{[3
]}

Boehne, Martin ^{[4
]}

Weigelt, Annika ^{[5
]}

Wagner, Robert ^{[6
]}

Mueller, Goetz ^{[7
]}

Rentzsch, Axel ^{[8
,36
]}

zu Knyphausen, Edzard ^{[9
,25
,29
]}

Fischer, Marcus ^{[10
]}

Papakostas, Konstantin ^{[11
]}

Wiegand, Gesa ^{[12
]}

Ruf, Bettina ^{[13
]}

Hannes, Tobias ^{[14
]}

Reineker, Katja ^{[15
]}

Kiski, Daniela ^{[16
]}

Khalil, Markus ^{[17
]}

Steinmetz, Michael ^{[18
,45
]}

Fischer, Gunther ^{[19
,44
]}

Pickardt, Thomas ^{[20
]}

Klingel, Karin ^{[21
]}

Messroghli, Daniel R. ^{[2
,22
,23
]}

Degener, Franziska ^{[1
,2
,24
]}

Berger, Felix ^{[9
,25
]}

Haverkaemper, Guido ^{[10
,26
]}

Klaassen, Sabine ^{[10
,26
,27
]}

Bauer, Manuela ^{[28
]}

Racolta, Anca ^{[29
]}

Kececioglu, Deniz ^{[29
]}

Trong Phi Le ^{[30
]}

Dittrich, Sven ^{[31
]}

Halbfass, Julia ^{[31
]}

Stiller, Brigitte ^{[32
]}

Kaufmann, Janina ^{[32
]}

Bauer, Juergen ^{[33
]}

Latus, Heiner ^{[33
]}

Lux, Christian ^{[33
]}

Schranz, Dietmar ^{[33
]}

Kozlik-Feldmann, Rainer ^{[34
]}

Mir, Thomas ^{[34
]}

Schlesner, Claudia ^{[34
]}

Schmidt, Florian ^{[10
,26
]}

Jack, Thomas ^{[35
]}

Beerbaum, Philipp ^{[35
]}

Pontius, Sandra ^{[36
]}

Abdul-Khaliq, Hashim ^{[36
]}

Brockmeier, Konrad ^{[37
]}

Daehnert, Ingo ^{[38
]}

Richter, Jacqueline ^{[38
]}

Engelhardt, Andrea ^{[39
]}

Ewert, Peter ^{[39
]}

机构：

[1] German Heart Ctr Berlin, Dept Congenital Heart Dis Pediat Cardiol, Augustenburger Pl 1, D-13353 Berlin, Germany

[2] DZHK German Ctr Cardiovasc Res, Berlin, Germany

[3] Charite Univ Med Berlin, Dept Pediat Cardiol, Berlin, Germany

[4] Hannover Med Sch, Dept Pediat Cardiol & Intens Care Med, Hannover, Germany

[5] Univ Hosp Erlangen, Dept Pediat Cardiol, Erlangen, Germany

[6] Herzzentrum Leipzig, Dept Pediat Cardiol, Leipzig, Germany

[7] Univ Herzzentrum Hamburg, Dept Pediat Cardiol, Hamburg, Germany

[8] Univ Klinikum Saarlandes, Dept Pediat Cardiol, Homburg, Germany

[9] Herz & Diabet Zentrum NRW, Dept Pediat Cardiol, Bad Oeynhausen, Germany

[10] Ludwig Maximilians Univ Munchen, Dept Pediat Cardiol & Pediat Intens Care, Munich, Germany

[11] Klinikum Links Weser, Dept Pediat Cardiol, Bremen, Germany

[12] Univ Hosp Tubingen, Dept Pediat Cardiol, Tubingen, Germany

[13] Deutsch Herzzentrum Munich, Dept Pediat Cardiol, Munich, Germany

[14] Univ Hosp Koln, Dept Pediat Cardiol, Cologne, Germany

[15] Univ Herzzentrum Freiburg Bad Krozingen, Dept Pediat Cardiol, Freiburg, Germany

[16] Univ Hosp Munster, Dept Pediat Cardiol, Munster, Germany

[17] Univ Hosp Giessen, Dept Pediat Cardiol, Giessen, Germany

[18] Univ Med Gottingen, Dept Pediat Cardiol, Gottingen, Germany

[19] Univ Hosp Schleswig Holstein, Dept Pediat Cardiol, Kiel, Germany

[20] Kompetenznetz Angeborene Herzfehler, Berlin, Germany

[21] Univ Hosp Tubingen, Cardiopathol, Inst Pathol & Neuropathol, Tubingen, Germany

[22] Deutsch Herzzentrum Berlin, Dept Cardiol, Berlin, Germany

[23] Charite Univ Med Berlin, Dept Cardiol, Berlin, Germany

[24] Charite Univ Med Berlin, Inst Cardiovasc Comp Assisted Med, Berlin, Germany

[25] Charite Univ Med Berlin, DZHK Partner Site Berlin, German Heart Ctr Berlin, Berlin, Germany

[26] Charite Univ Med Berlin, Berlin, Germany

[27] ECRC, Berlin, Germany

[28] German Heart Ctr Berlin, Berlin, Germany

[29] Herz & Diabet Zentrum Nordrhein Westfahlen, Bad Oeynhausen, Germany

[30] Klinikum Links Weser, Bremen, Germany

[31] Univ Klinikum Erlangen, Erlangen, Germany

[32] Univ Herzzentrum Freiburg Bad Krozingen, Freiburg, Germany

[33] Univ Klinikum Giessen, Giessen, Germany

[34] Univ Herzzentrum Hamburg, Hamburg, Germany

[35] Hannover Med Sch, Hannover, Germany

[36] Univ Klinikum Saarlandes, Homburg, Germany

[37] Uniklin Koln, Cologne, Germany

[38] Herzzentrum Leipzig, Leipzig, Germany

[39] Deutsch Herzzentrum Munich, Munich, Germany

[40] Univ Klinikum Munster, Munster, Germany

[41] Univ Klinikum Tubingen, Tubingen, Germany

[42] Klinikum Univ Munchen, Campus Grosshadern, Munich, Germany

[43] Univ Klinikum Ulm, Ulm, Germany

[44] Univ Klinikum Schleswig Holstein, Campus Kiel, Kiel, Germany

[45] Univ Med Gottingen, Gottingen, Germany

[46] Univ Klinikum Bonn, Bonn, Germany

[47] Competence Network Congenital Heart Defects, Berlin, Germany

[48] Univ Med Ctr Gottingen, Dept Med Stat, Gottingen, Germany

来源：

PEDIATRIC TRANSPLANTATION | 2019年 / 23卷 / 07期

关键词：

MCS; myocarditis; pediatric; transplantation; SUDDEN CARDIAC DEATH; ACUTE-FULMINANT; DIAGNOSIS; CHILDREN; CARDIOMYOPATHY; CARDIOLOGY; OUTCOMES; SOCIETY; DEFINITION;

D O I：

10.1111/petr.13548

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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%.

引用

页数：10

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