Cardiology · Pediatrics · 3 h ago
Left ventricular function predicts early adverse outcomes in paediatric myocarditis
A prospective multicentre registry analysis of 725 children with myocarditis identified presenting left ventricular ejection fraction as the only robust predictor of major adverse cardiovascular events during initial admission. Discrimination was maintained in an external Swedish cohort of 243 patients.
- MACE occurred in 12.2% of 725 MYKKE registry patients.
- Presenting LVEF was the only robust early risk stratifier.
- Discrimination persisted in an external cohort of 243 patients.
- Younger children more often showed a higher-risk heart-failure pattern.
An analysis of the prospective multicentre MYKKE registry examined early risk stratification in 725 paediatric patients with possible or definite myocarditis enrolled during 2013–2024. Investigators assessed 20 baseline variables for predicting major adverse cardiovascular events (MACE), defined as mechanical circulatory support, heart transplantation or death during the initial admission. Median age was 14.3 years, and 33% were female.
MACE occurred in 88 patients (12.2%); mechanical support, transplantation and death occurred in 10.9%, 4.3% and 2.2%, respectively. Left ventricular ejection fraction (LVEF) ≤39% was the only stable risk stratifier identified by model-based partitioning. Each percentage-point increase in LVEF was associated with lower odds of MACE (odds ratio 0.90; 95% CI 0.881–0.917). Model discrimination was high in MYKKE (AUC 0.90) and maintained in the external Swedish SWEDCON cohort of 243 patients (AUC 0.894; 95% CI 0.80–0.991), where 7.4% experienced MACE.
Two age-associated patterns emerged: a higher-risk heart-failure presentation in younger children and a lower-risk chest-pain presentation in adolescents with preserved LVEF. The findings support presenting LVEF as an early inpatient risk marker, but this observational analysis does not establish that threshold-guided management improves outcomes. Results concern index-hospitalisation events, not longer-term prognosis; assessment here is limited to the abstract.
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ESC Heart Failure: Age-associated clinical patterns in paediatric myocarditis: left ventricular function as the key early risk stratifier ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.