The diagnosis and treatment of pediatric clinical myocarditis in China: a multicenter retrospective study

作者全名："Li, Xiaoou; Tuo, Hu; Huang, Yijuan; Li, Yan; Zhao, Naicheng; Wang, Juanli; Liu, Ying; Peng, Hua; Xu, Xinyi; Peng, Qian; Hu, Xiaoping; Zhang, Bin; Li, Zipu; Chen, Mingwu; Zhao, Sheng; Jin, Hongfang; Xiong, Zhenyu; Wu, Xiaoyun; Pan, Jinyong; Wang, Xiaoning; Zhang, Yiying; Lin, Shi; He, Bing; Du, Junbao"

作者地址："[Li, Xiaoou; Tuo, Hu; He, Bing] Wuhan Univ, Renmin Hosp, Dept Pediat, Wuhan 430060, Peoples R China; [Huang, Yijuan] China Three Gorges Univ, Yichang Cent Peoples Hosp, Coll Clin Med Sci 1, Dept Pediat, Yichang 443000, Peoples R China; [Li, Yan] Zhengzhou Univ, Dept Pediat, Affiliated Hosp 3, Zhengzhou 450000, Peoples R China; [Zhao, Naicheng] Nanjing Med Univ, Dept Pediat, Childrens Hosp, Nanjing 210000, Peoples R China; [Wang, Juanli] Xi An Jiao Tong Univ, Xian Childrens Hosp, Dept Cardiovasc Med, Childrens Hosp, Xian 710003, Peoples R China; [Liu, Ying; Peng, Hua] Peking Univ, Dept Pediat, Shenzhen Hosp, Shenzhen 518000, Peoples R China; [Xu, Xinyi] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Sch Med, Dept Cardiol, Shanghai 200000, Peoples R China; [Peng, Qian; Hu, Xiaoping] Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Dept Pediat, Chengdu 610000, Peoples R China; [Zhang, Bin] Soochow Univ, Dept Pediat Cardiol, Childrens Hosp, Suzhou 215000, Peoples R China; [Li, Zipu] Qingdao Univ, Women & Childrens Hosp, Dept Pediat, Qingdao 266000, Peoples R China; [Chen, Mingwu] Univ Sci & Technol China, Affiliated Hosp USTC 1, Dept Pediat, Div Life Sci & Med, Hefei 230000, Peoples R China; [Zhao, Sheng] Anhui Prov Childrens Hosp, Dept Cardiol, Hefei 230000, Peoples R China; [Jin, Hongfang; Du, Junbao] Peking Univ First Hosp, Dept Pediat, Beijing 100000, Peoples R China; [Xiong, Zhenyu] Kaifeng Childrens Hosp, Dept Pediat, Kaifeng 475000, Peoples R China; [Wu, Xiaoyun] Chongqing Med Univ, Dept Cardiol, Childrens Hosp, Minist Educ,Key Lab Child Dev & Disorders, Chongqing 40014, Peoples R China; [Pan, Jinyong] Shihezi Univ, Dept Pediat, Affiliated Hosp 1, Shihezi 832000, Peoples R China; [Wang, Xiaoning] Hebei Med Univ, Dept Pediat, Hosp 2, Shijiazhuang 050000, Peoples R China; [Zhang, Yiying] Zhejiang Univ, Childrens Hosp, Dept Pediat, Sch Med, Hangzhou 310000, Peoples R China; [Lin, Shi] Childrens Hosp, Capital Inst Pediat, Dept Cardiol, Beijing 100020, Peoples R China"

通信作者："He, B (通讯作者)，Wuhan Univ, Renmin Hosp, Dept Pediat, Wuhan 430060, Peoples R China.; Du, JB (通讯作者)，Peking Univ First Hosp, Dept Pediat, Beijing 100000, Peoples R China."

来源：EUROPEAN JOURNAL OF PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001125285300001

JCR分区：Q1

影响因子：3

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Pediatric myocarditis; Multicenter clinical study; Clinical characteristics; Outcomes

摘要："This study aims to examine the clinical characteristics and outcomes of clinical myocarditis in pediatric patients in China. This is a multicenter retrospective study. Children diagnosed with clinical myocarditis from 20 hospitals in China and admitted between January 1, 2015, and December 30, 2021, were enrolled. The clinical myocarditis was diagnosed based on the ""Diagnostic Recommendation for Myocarditis in Children (Version 2018)"". The clinical data were collected from their medical records. A total of 1210 patients were finally enrolled in this study. Among them, 45.6% had a history of respiratory tract infection. An abnormal electrocardiogram was observed in 74.2% of patients. Echocardiography revealed that 32.3% of patients had a left ventricular ejection fraction of less than 50%. Cardiac MRI was performed in 4.9% of children with clinical myocarditis, of which 61% showed localized or diffuse hypersignal on T2-weighted images. Serum levels of cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), and N-terminal B-type natriuretic peptide (NT-proBNP) were higher in patients with fulminant myocarditis than in patients with myocarditis, making them potential risk factors for fulminant myocarditis. Following active treatment, 12.1% of patients were cured, and 79.1% were discharged with improvement.Conclusion: Clinical myocarditis in children often presents with symptoms outside the cardiovascular system. CK-MB, cTnI, and NT-proBNP are important indicators for assessing clinical myocarditis. The electrocardiogram and echocardiogram findings in children with clinical myocarditis exhibit significant variability but lack specificity. Cardiac MRI can be a useful tool for screening clinical myocarditis. Most children with clinical myocarditis have a favorable prognosis.What is Known:center dot Pediatric myocarditis presents complex clinical manifestations and exhibits varying degrees of severity. Children with mild myocarditis generally have a favorable prognosis, while a small number of children with critically ill myocarditis experience sudden onset, hemodynamic disorders, and fatal arrhythmias. Therefore, early diagnosis and timely treatment of myocarditis are imperative.What is New:center dot To the best of our knowledge, this multicenter retrospective study is the largest ever reported in China, aiming to reveal the clinical characteristics and outcomes of pediatric clinical myocarditis in China. We provided an extensive analysis of the clinical characteristics, diagnosis, treatment, prognosis, and factors impacting disease severity in pediatric clinical myocarditis in China, which provides insights into the epidemiological characteristics of pediatric clinical myocarditis."

基金机构：　

基金资助正文：