Long-term outcome of acute myocarditis is independent of cardiac enzyme release.
BACKGROUND
There are few data concerning prognostic markers of acute myocarditis. The purpose of this study was to assess the prognostic value of initial measurements of creatine kinase (CK), cardiac troponin I (cTnI) and myoglobin as regards late recovery of the left ventricular ejection fraction on follow-up.


METHODS
A total of 22 patients (53+/-15 years old, 11 female) with acute myocarditis were followed up in a prospective observational study. Of these, 11 (50%) showed a history of acute infection prior to hospitalisation and seven (32%) had pericardial effusion. The median ejection fraction during the acute phase was 47+/-17%; after a mean follow-up of 119+/-163 days it improved to 60+/-9% (P<0.001). Considering maximal CK-rise values of 641+/-961 U/l (P=0.38), cTnI-rise values of 3.7+/-8.6 microg/l (P=0.16) and myoglobin values of 7.4+/-12 nmol/l (P=0.69), there was no correlation between initial cardiac enzyme levels and the initial and late left ventricular ejection fraction.


CONCLUSIONS
After acute myocarditis, there is late recovery of left ventricular ejection fraction, which is independent of the initial myocardial damage measured by cardiac enzyme release.
Ammann
Peter
P
Division of Cardiology, Department of Internal Medicine, Triemli Hospital Zurich, 8063, Zurich, Switzerland. pammann@swissonline.ch <pammann@swissonline.ch>
Naegeli
Barbara
B
Schuiki
Ernst
E
Straumann
Edwin
E
Frielingsdorf
Jürgen
J
Rickli
Hans
H
Bertel
Osmund
O
D000208:Acute Disease; D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology*; D009211:Myoglobin / Q000097:blood / Q000378:metabolism*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology*; D019210:Troponin I / Q000097:blood / Q000378:metabolism*; D016277:Ventricular Function, Left / Q000502:physiology*
D009211:Myoglobin; D019210:Troponin I; D003402:Creatine Kinase