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Left ventricular end-diastolic dimension as a predictive factor of outcomes in children with acute myocarditis

Published online by Cambridge University Press:  26 May 2016

Geena Kim Open the ORCID record for Geena Kim [Opens in a new window] ,
Gil-Ho Ban ,
Hyoung-Doo Lee ,
Si-Chan Sung ,
Hyungtae Kim  and
Kwang-Ho Choi
Geena Kim
Affiliation:
Heart Center, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
Gil-Ho Ban
Affiliation:
Heart Center, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
Hyoung-Doo Lee*
Affiliation:
Heart Center, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
Si-Chan Sung
Affiliation:
Heart Center, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
Hyungtae Kim
Affiliation:
Heart Center, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
Kwang-Ho Choi
Affiliation:
Heart Center, Pusan National University Children’s Hospital, Yangsan, Republic of Korea
*
Correspondence to: H. D. Lee, MD, PhD, Department of Pediatrics, Pusan National University Children’s Hospital, Beomeu-li, Mulgum-eup, Yangsan, Keungsangnam-do 626-770, Republic of Korea. Tel: +82 55 360 3600; Fax: +82 55 360 2181; E-mail: hdlee@pusan.ac.kr
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Abstract

In this study, we sought predictors of mortality in children with acute myocarditis and of incomplete recovery in the survivor group. We classified our patients into three groups according to their outcomes at last follow-up: full recovery was classified as group I, incomplete recovery was classified as group II, and death was classified as group III. In total, 55 patients were enrolled in the study: 33 patients in group I, 11 patients in group II, and 11 patients in group III. The initial left ventricular fractional shortening – left ventricular fractional shortening – was significantly lower in group III (p=0.001), and the left ventricular end-diastolic dimension z score was higher in groups II and III compared with group I (p=0.000). A multivariate analysis showed that the left ventricular end-diastolic dimension z score (odds ratio (OR), 1.251; 95% confidence interval (CI), 1.004–1.559), extracorporeal membrane oxygenation (OR, 9.842; 95% CI, 1.044–92.764), and epinephrine infusion (OR, 18.552; 95% CI, 1.759–195.705) were significant predictors of mortality. The left ventricular end-diastolic dimension z score was the only factor that predicted incomplete recovery in the survivor group (OR, 1.360; 95% CI, 1.066–1.734; p=0.013). The receiver operating characteristic curve of the left ventricular end-diastolic dimension z score at admission showed a cut-off level of 3.01 for predicting mortality (95% CI, 0.714–0.948). In conclusion, a high left ventricular end-diastolic dimension z score on admission was a significant predictor of worse outcomes, both regarding mortality and incomplete recovery.

Keywords

Myocarditischildoutcomepredictor
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 3 , March 2017 , pp. 443 - 451
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Copyright
© Cambridge University Press 2016 

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