Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry "MYKKE"
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Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry "MYKKE". / Schubert, Stephan; Opgen-Rhein, Bernd; Boehne, Martin; Weigelt, Annika; Wagner, Robert; Müller, Götz; Rentzsch, Axel; Zu Knyphausen, Edzard; Fischer, Marcus; Papakostas, Konstantin; Wiegand, Gesa; Ruf, Bettina; Hannes, Tobias; Reineker, Katja; Kiski, Daniela; Khalil, Markus; Steinmetz, Michael; Fischer, Gunther; Pickardt, Thomas; Klingel, Karin; Messroghli, Daniel R; Degener, Franziska; MYKKE consortium.
in: PEDIATR TRANSPLANT, Jahrgang 23, Nr. 7, e13548, 11.2019.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry "MYKKE"
AU - Schubert, Stephan
AU - Opgen-Rhein, Bernd
AU - Boehne, Martin
AU - Weigelt, Annika
AU - Wagner, Robert
AU - Müller, Götz
AU - Rentzsch, Axel
AU - Zu Knyphausen, Edzard
AU - Fischer, Marcus
AU - Papakostas, Konstantin
AU - Wiegand, Gesa
AU - Ruf, Bettina
AU - Hannes, Tobias
AU - Reineker, Katja
AU - Kiski, Daniela
AU - Khalil, Markus
AU - Steinmetz, Michael
AU - Fischer, Gunther
AU - Pickardt, Thomas
AU - Klingel, Karin
AU - Messroghli, Daniel R
AU - Degener, Franziska
AU - MYKKE consortium
N1 - © 2019 Wiley Periodicals, Inc.
PY - 2019/11
Y1 - 2019/11
N2 - Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty-eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0-2 years) than in the older groups (P < 0.001; 2-12 and 13-18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death (P < 0.001). Myocarditis represents a life-threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life-saving therapeutic option in children with myocarditis with a weaning rate of 43%.
AB - Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty-eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0-2 years) than in the older groups (P < 0.001; 2-12 and 13-18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death (P < 0.001). Myocarditis represents a life-threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life-saving therapeutic option in children with myocarditis with a weaning rate of 43%.
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Female
KW - Heart Failure/diagnosis
KW - Heart Transplantation
KW - Heart-Assist Devices
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Myocarditis/complications
KW - Prospective Studies
KW - Registries
KW - Severity of Illness Index
KW - Treatment Outcome
U2 - 10.1111/petr.13548
DO - 10.1111/petr.13548
M3 - SCORING: Journal article
C2 - 31297930
VL - 23
JO - PEDIATR TRANSPLANT
JF - PEDIATR TRANSPLANT
SN - 1397-3142
IS - 7
M1 - e13548
ER -
