Long term follow up of children with myocarditis treated by immunosuppression and of children with dilated cardiomyopathy
| Autor: | Renata Boldrini, Carlo Bassano, Alessandra Fierabracci, M Giulia Gagliardi, A G Ugazio, G. F. Bottazzo, F. Diomedi Camassei, Benedetta Leonardi, M. Bevilacqua |
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| Rok vydání: | 2004 |
| Předmět: |
Male
genetic structures Heart disease recurrent disease Biopsy medicine.medical_treatment Left Congestive Cardiomyopathy Cardiovascular Medicine Gastroenterology Settore ICAR/01 - Idraulica Prednisone congestive cardiomyopathy dose response Dilated Ventricular Dysfunction Child hirsutism Age Factors article immunosuppressive treatment Immunosuppression Dilated cardiomyopathy cohort analysis Myocarditis congestive heart failure female priority journal Cohort histopathology Cyclosporine Cardiology Cardiology and Cardiovascular Medicine Immunosuppressive Agents medicine.drug survival rate medicine.medical_specialty Internal medicine medicine follow up Humans controlled study human drug dose reduction Preschool Immunosuppression Therapy Heart Failure Analysis of Variance business.industry Patient Selection Infant convalescence immunosuppressive agent medicine.disease major clinical study human tissue pericardial effusion cyclosporin heart muscle biopsy Heart failure prednisone heart left ventricle function treatment outcome business child male myocarditis Cardiomyopathy Dilated Child Preschool Endocardium Female Follow-Up Studies Heart Failure Congestive Ventricular Dysfunction Left |
| Zdroj: | Heart. 90:1167-1171 |
| ISSN: | 1355-6037 |
| DOI: | 10.1136/hrt.2003.026641 |
| Popis: | Objective: To describe the treatment and long term outcome after immunosuppressive treatment of children with myocarditis. Methods and results: 114 patients with newly diagnosed dilated cardiomyopathy were divided into three groups, according to the histological pattern: group A, acute myocarditis; group B, borderline myocarditis; and group C, non-inflammatory cardiomyopathy. Groups A and B were treated with cyclosporine and prednisone in addition to conventional treatment. Survivors of the whole cohort were analysed for 13 year transplant-free survival and assessed for left ventricular function. Event-free survival at 13 years was 97 (3)% for group A, 70 (8)% for group B, and 32 (7)% for group C (p < 0.0001). It was 96 (4)% at one year and 83 (5)% at 13 years for the cumulated myocarditis group (A and B). Cardiac function recovered completely in 79% of survivors in group A, 64% in group B, and 36% in group C. The rate of complete recovery in the cumulated group (A and B) was 70%. Conclusions: The high long term survival rate of this cohort of children with myocarditis is probably due to the effect of short term immunosuppression. This result differs from previously published series of conventionally treated children, whose survival probability at one year was about 60%. |
| Databáze: | OpenAIRE |
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