National survey of fulminant myocarditis in Japan: therapeutic guidelines and long-term prognosis of using percutaneous cardiopulmonary support for fulminant myocarditis (special report from a scientific committee).
Although fulminant myocarditis is known as a fatal disease, patients have been able to recover and return to normal life with the help of mechanical cardiopulmonary support. However, therapeutic guidelines for using percutaneous cardiopulmonary support (PCPS) for fulminant myocarditis have not been established, and the clinical course and long-term prognosis of such patients are still controversial issues. The present national survey considered the current situation of patients as the basis for proposing therapeutic guidelines. Thirty of 52 patients (57.7%) survived and returned to social life. Important factors concerning the prognosis were the severity and grade of cardiac and renal dysfunction, the adjusted support flow rate to enable recovery from circulatory failure, and prevention of circulatory disturbances of the legs and multiple organ failure directly associated with PCPS. With regard to the long-term prognosis of patients treated with PCPS, the readmission rate was 10%, the exacerbation rate was 3.3%, and mortality was 10% during the average follow-up period of 962 days. Optimal management of the mechanical cardiopulmonary support and curative treatment for the myocarditis further improve the outcome of this disease.
Aoyama
Naoyoshi
N
Department of Internal Medicine and Cardiology, Kitasato University School of Medicine, Sagamihara, Japan.
Izumi
Tohru
T
Hiramori
Katsuhiko
K
Isobe
Mitsuaki
M
Kawana
Masatoshi
M
Hiroe
Michiaki
M
Hishida
Hitoshi
H
Kitaura
Yasushi
Y
Imaizumi
Tsutomu
T
D001784:Blood Gas Analysis / Q000592:standards; D006328:Cardiac Catheterization / Q000592:standards; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000097:blood / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome