A National Survey on Myocarditis Associated With the 2009 Influenza A (H1N1) Pandemic in Japan
A National Survey on Myocarditis Associated With the 2009 Influenza A (H1N1) Pandemic in Japan
复制标题
DOI：
10.1253/circj.cj-10-0452
复制
发表时间：
2010-10-01
影响因子：
3.3
通讯作者：
Matsumori, Akira
中科院分区：
文献类型：
--
作者：
Ukimura, Akira;Izumi, Tohru;Matsumori, Akira
工作背景：2009年发生了流感大流行，从2009年8月开始，在住院患者中报告了与2009年甲型H1N1流感大流行相关的心肌炎。方法和结果：日本循环学会组织了2009年甲型H1N1流感相关心肌炎临床研究委员会，并呼吁报告心肌炎病例进行全国调查。使用心肌炎诊断和治疗指南（JCS 2009）诊断心肌炎。有15名患者向委员会报告。暴发性心肌炎10例。所有10例患者均采用机械循环支持（主动脉内球囊反搏（IABP）和/或经皮心肺支持（PCPS）），其中8例抢救成功。大部分患者超声心动图异常，心肌酶升高。6例经心肌内膜活检发现心肌炎。三名患者并发症与pneumonia.Conclusions：在现实中，心肌炎与大流行性流感A（H1N1）似乎是更常见的住院患者相比，以前的季节性流感病毒爆发。为避免2009年甲型H1N1流感大流行相关急性心肌炎的误诊，确定流感大流行期间急性心肌炎的特征性症状、体征和实验室检查结果至关重要。抢救暴发性心肌炎患者需要机械循环支持（IABP和/或PCPS）。(Circ J 2010; 74：2193-2199）
Background: An influenza pandemic occurred in 2009 and myocarditis associated with the 2009 influenza A (H1N1) pandemic was reported among hospitalized patients from August 2009.Methods and Results: The Japanese Circulation Society organized the Clinical Research Committee on Myocarditis Associated with Influenza Pandemic A (H1N1) 2009 and called for a case report on myocarditis for a national survey. The diagnosis of myocarditis was performed using the Guidelines for the Diagnosis and Treatment of Myocarditis (JCS 2009). Fifteen patients were reported to the committee. Fulminant myocarditis developed in 10 patients. Mechanical circulatory support (intra-aortic balloon pumping (IABP) and/or percutaneous cardiopulmonary support (PCPS)) was used on all 10 patients, 8 of whom were rescued. Abnormalities on echocardiography and elevated cardiac enzymes were seen in most of the patients. Myocarditis was found by endomyocardial biopsy in 6 patients. Three patients had complications with pneumonia.Conclusions: In reality, myocarditis associated with pandemic influenza A (H1N1) seemed to be more common in hospitalized patients, compared with previous seasonal influenza virus outbreaks. To avoid misdiagnosis of acute myocarditis associated with influenza pandemic A (H1N1) 2009, it is essential to determine the characteristic symptoms, signs, and laboratory findings of acute myocarditis during influenza pandemics. Mechanical circulatory support (IABP and/or PCPS) was required to rescue patients with fulminant myocarditis. (Circ J 2010; 74: 2193-2199)