Myocarditis Causing Premature Ventricular Contractions
| Autor: | Valay Parikh, Mark J. Hamblin, Luigi Di Biase, Dhanunjaya Lakkireddy, Sanghamitra Mohanty, Sudharani Bommana, Heidi Carroll, Mohit K. Turagam, Donita Atkins, Thomas Rosamond, Megan Krause, Tawseef Dar, Cheri Nydegger, Bharath Yarlagadda, Andrea Natale, Rakesh Gopinathannair, Louis Wetzel |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Myocarditis Biopsy medicine.medical_treatment Catheter ablation Inflammation Ventricular Function Left Fluorodeoxyglucose F18 Heart Rate Risk Factors Physiology (medical) Internal medicine medicine Humans Prospective Studies Registries Aged medicine.diagnostic_test business.industry Disease progression Stroke Volume Recovery of Function Middle Aged medicine.disease Magnetic Resonance Imaging Ventricular Premature Complexes United States Treatment Outcome Positron emission tomography Positron-Emission Tomography Catheter Ablation Cardiology Female Radiopharmaceuticals medicine.symptom Presentation (obstetrics) Cardiology and Cardiovascular Medicine business Immunosuppressive Agents |
| Zdroj: | Circulation: Arrhythmia and Electrophysiology. 12 |
| ISSN: | 1941-3084 1941-3149 |
| Popis: | Background: Premature ventricular contractions are a common clinical presentation that drives further diagnostic workup. We hypothesize the presence of underlying inflammation is often unrecognized in these patients with a potential for continued disease progression if not diagnosed and treated early in the disease course. Methods: This is a single-center, prospective study including 107 patients with frequent symptomatic premature ventricular contractions (>5000/24 h) and no known ischemic heart disease. Patients underwent a combination of laboratory testing, 18F-fluorodeoxyglucose positron emission tomography scan, cardiac magnetic resonance imaging, and biopsy. Patients were diagnosed with myocarditis based on a multidisciplinary approach and treated with immunosuppressive therapy. Results: The mean age of the cohort was 57±15 years, 41% were males, and left ventricular ejection fraction was 47±11.8%. Positive positron emission tomography scan was seen in 51% (55/107), of which 51% (28/55) had preserved left ventricle function. Based on clinical profile, 18F-fluorodeoxyglucose—positron emission tomography imaging, cardiac magnetic resonance, and histological data 58% patients (32/55) received immunosuppressive therapy alone and 25.4% (14/55) received immunosuppressive therapy and catheter ablation. Optimal response was seen in 67% (31/46) over a mean follow-up of 6±3 months. In patients with left ventricle systolic dysfunction, 37% (10/27) showed an improvement in mean left ventricular ejection fraction of 13±6%. Conclusions: Approximately 51% of patients presenting with frequent premature ventricular contractions have underlying myocardial inflammation in this cohort. 18F-fluorodeoxyglucose—positron emission tomography scan can be a useful modality for early diagnosis and treatment with immunosuppressive therapy in selected patients can improve clinical outcomes. |
| Databáze: | OpenAIRE |
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