Early and long-term mortality of the clinical subtypes of myocarditis
Early and long-term mortality of the clinical subtypes of myocarditis
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DOI：
10.1253/jcj.65.961
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发表时间：
2001-11-01
期刊：
影响因子：
--
通讯作者：
Izumi, T
中科院分区：
文献类型：
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作者：
Kodama, M;Oda, H;Izumi, T
心肌炎的发生频率和患者的预后仍不确定，而且心肌炎的临床分类也存在争议。从1985年到2000年，在11个心血管中心收治了71名临床疑似心肌炎的成人患者。其中经组织学证实的心肌炎48例，其中淋巴细胞性心肌炎41例，巨细胞性心肌炎6例，嗜酸性心肌炎1例。根据发病时间将心肌炎分为急性心肌炎(30例)和慢性心肌炎(18例)，根据心力衰竭患者是否需要机械循环支持，将急性心肌炎进一步分为普通型和暴发型(分别为9例和21例)。慢性心肌炎分为3个亚型：起病3个月以上的持续型(3例)、复发型(2例)和潜伏型(13例)。急性普通型心肌炎早期死亡率为22%，急性迁延型心肌炎早期死亡率为43%，慢性迁延型心肌炎早期死亡率为33%，慢性复发性心肌炎早期死亡率为50%，慢性潜伏型心肌炎早期死亡率为38%。尽管在住院期间进行了积极的治疗，但所有心肌炎患者的总早期死亡率为38%。心肌炎患者远期预后良好，仅4例存活活动期晚期死亡：1例为暴发型心肌炎，3例为慢性潜伏型心肌炎。因此，无论亚型如何，心肌炎患者的早期死亡率都很高，但如果患者能挺过活动期，除了慢性潜伏期外，他们的预后良好。
The frequency of myocarditis and the prognosis for patients remains uncertain and, moreover, the clinical classification of myocarditis is controversial. From 1985 to 2000, 71 adult patients with clinically suspected myocarditis were admitted to 11 cardiovascular centers. Of these, 48 cases had histology proven myocarditis: 41 cases of lymphocytic myocarditis, 6 of giant cell myocarditis and 1 of eosinophilic myocarditis. Myocarditis was classified as acute (30 cases) or chronic (18 cases) according to the onset of the disease, and acute myocarditis was further categorized into common or fulminant type depending on whether or not patients required mechanical circulatory support in the management of heart failure (9 and 21 cases, respectively). Chronic myocarditis was divided into 3 subgroups: a persistent type lasting over 3 months after distinct onset (3 cases), a recurrent type (2 cases) and a latent form (13 cases). The early mortality of these 5 subtypes of myocarditis were acute common 22%, acute fluminant 43%, chronic persistent 33%, chronic recurrent 50%, and chronic latent 38%. The overall early mortality of all patients with myocarditis was 38% in spite of aggressive treatment during hospitalization. On the other hand, the long-term prognosis of patients with myocarditis was favorable, only 4 cases, who survived the active phase, died in the late phase: 1had fulminant myocarditis and the other 3 had the chronic latent form. Thus, the early mortality of patients with myocarditis was very high regardless of the subtype, but if patients can survive the active phase, they have a favorable prognosis except with the chronic latent form.