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Exercise testing in patients with multisystem inflammatory syndrome in children-related myocarditis versus idiopathic or viral myocarditis

Published online by Cambridge University Press:  10 January 2023

Daniel Ziebell Open the ORCID record for Daniel Ziebell [Opens in a new window] ,
Trisha Patel ,
Megan Stark ,
Yijin Xiang  and
Matthew E. Oster Open the ORCID record for Matthew E. Oster [Opens in a new window]
Daniel Ziebell
Affiliation:
Emory University, Atlanta, GA, USA
Trisha Patel
Affiliation:
Emory University, Atlanta, GA, USA
Megan Stark
Affiliation:
Children’s Healthcare of Atlanta, Atlanta, GA, USA
Yijin Xiang
Affiliation:
Pediatric Biostatistics Core, Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University, Atlanta, GA, USA
Matthew E. Oster*
Affiliation:
Emory University, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
*
Author for correspondence: Matthew Oster, MD MPH, Department of Pediatrics, Emory University School of Medicine, 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341, USA. Tel: +1 404 256 2593; Fax: +1 770 488 9431. E-mail: osterm@kidsheart.com
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Abstract

Background:

While most children with multisystem inflammatory syndrome in children have rapid recovery of cardiac dysfunction, little is known about the long-term outcomes regarding exercise capacity. We aimed to compare the exercise capacity among patients with multisystem inflammatory syndrome in children versus viral/idiopathic myocarditis at 3–6 months after initial diagnosis.

Methods:

We performed a retrospective cohort study among patients with multisystem inflammatory syndrome in children in June 2020 to May 2021 and patients with viral/idiopathic myocarditis in August 2014 to January 2020. Data from cardiopulmonary exercise test as well as echocardiographic and laboratory data were obtained. Inclusion criteria included diagnosis of multisystem inflammatory syndrome in children or viral/idiopathic myocarditis, exercise test performed within 3–6 months of hospital discharge, and maximal effort on cardiopulmonary exercise test as determined by respiratory exchange ratio >1.10.

Results:

Thirty-one patients with multisystem inflammatory syndrome in children and 25 with viral/idiopathic myocarditis were included. The mean percent predicted peak VO2 was 90.84% for multisystem inflammatory syndrome in children patients and 91.08% for those with viral/idiopathic myocarditis (p-value 0.955). There were no statistically significant differences between the groups with regard to percent predicted maximal heart rate, metabolic equivalents, percent predicted peak VO2, percent predicted anerobic threshold, or percent predicted O2 pulse. There was a statistically significant correlation between lowest ejection fraction during hospitalisation and peak VO2 among viral/idiopathic myocarditis patients (r: 0.62, p-value 0.01) but not multisystem inflammatory syndrome in children patients (r: 0.1, p-value 0.6).

Conclusions:

Patients with multisystem inflammatory syndrome in children and viral myocarditis appear to, on average, have normal exercise capacity around 3–6 months following hospital discharge. For patients with viral/idiopathic myocarditis, those with worse ejection fraction during hospitalisation had lower peak VO2 on cardiopulmonary exercise test.

Keywords

Multisystem inflammatory disorder in childrenmyocarditiscardiopulmonary exercise testfunctional capacity
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 11 , November 2023 , pp. 2215 - 2220
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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