title: Good prognosis for pericarditis with and without myocardial involvement: results from a multicenter, prospective cohort study.
abstract: BACKGROUND
  The natural history of myopericarditis/perimyocarditis is poorly known, and recently published studies have presented contrasting data on their outcomes. The aim of the present article is to assess the prognosis of myopericarditis/perimyocarditis in a multicenter, prospective cohort study.
  
  
  RESULTS
  A total of 486 patients (median age, 39 years; range, 18-83 years; 300 men) with acute pericarditis or a myopericardial inflammatory syndrome (myopericarditis/perimyocarditis; 85% idiopathic, 11% connective tissue disease or inflammatory bowel disease, 5% infective) were prospectively evaluated from January 2007 to December 2011. The diagnosis of acute pericarditis was based on the presence of 2 of 4 clinical criteria (chest pain, pericardial rubs, widespread ST-segment elevation or PR depression, and new or worsening pericardial effusion). Myopericardial inflammatory involvement was suspected with atypical ECG changes for pericarditis, arrhythmias, and cardiac troponin elevation or new or worsening ventricular dysfunction on echocardiography and confirmed by cardiac magnetic resonance. After a median follow-up of 36 months, normalization of left ventricular function was achieved in >90% of patients with myopericarditis/perimyocarditis. No deaths were recorded, as well as evolution to heart failure or symptomatic left ventricular dysfunction. Recurrences (mainly as recurrent pericarditis) were the most common complication during follow-up and were recorded more frequently in patients with acute pericarditis (32%) than in those with myopericarditis (11%) or perimyocarditis (12%; P<0.001). Troponin elevation was not associated with an increase in complications.
  
  
  CONCLUSIONS
  The outcome of myopericardial inflammatory syndromes is good. Unlike acute coronary syndromes, troponin elevation is not a negative prognostic marker in this setting.
authors.affiliation: Cardiology Department, Maria Vittoria Hospital, Via Luigi Cibrario 72, 10141 Torino, Italy. massimo_imazio@yahoo.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Imazio
authors.forename: Antonio
authors.initials: A
authors.lastname: Brucato
authors.forename: Andrea
authors.initials: A
authors.lastname: Barbieri
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferroni
authors.forename: Silvia
authors.initials: S
authors.lastname: Maestroni
authors.forename: Guido
authors.initials: G
authors.lastname: Ligabue
authors.forename: Alessandra
authors.initials: A
authors.lastname: Chinaglia
authors.forename: Davide
authors.initials: D
authors.lastname: Cumetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Della Casa
authors.forename: Federica
authors.initials: F
authors.lastname: Bonomi
authors.forename: Francesca
authors.initials: F
authors.lastname: Mantovani
authors.forename: Paola
authors.initials: P
authors.lastname: Di Corato
authors.forename: Roberta
authors.initials: R
authors.lastname: Lugli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Faletti
authors.forename: Stefano
authors.initials: S
authors.lastname: Leuzzi
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Bonamini
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Modena
authors.forename: Riccardo
authors.initials: R
authors.lastname: Belli
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications; D001241:Aspirin / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003240:Connective Tissue Diseases / Q000150:complications; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications* / Q000188:drug therapy*; D010493:Pericarditis / Q000150:complications* / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D014336:Troponin / Q000097:blood; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D014336:Troponin; D001241:Aspirin; D007052:Ibuprofen
keywords: myopericarditis; pericarditis; perimyocarditis; prognosis