TY - JOUR T1 - Could the unfortunate outcome of pediatric acute myocarditis be predicted? Factors contributing to a poor outcome in myocarditis JO - Revista Portuguesa de Cardiologia (English edition) T2 - AU - Krasic,Stasa AU - Prijic,Sergej AU - Ninic,Sanja AU - Nesic,Dejan AU - Bjelakovic,Bojko AU - Petrovic,Gordana AU - Cerovic,Ivana AU - Vukomanovic,Vladislav SN - 21742049 M3 - 10.1016/j.repce.2020.10.020 DO - 10.1016/j.repce.2020.10.020 UR - https://revportcardiol.org/en-could-unfortunate-outcome-pediatric-acute-articulo-S217420492100252X AB - ObjectiveMyocarditis has spontaneous resolution in 50% of patients. Our study aimed to define risk factors for developing dilated cardiomyopathy (DCM) and death in pediatric patients with acute myocarditis (AM). MethodsThe retrospective cohort study included all patients with treated AM. The Mother and Child Health Institute from January 2011 to March 2019. ResultsIn the study, 62 patients were included, 40 boys and 22 girls (11.15±5.86 years) with AM. Twelve out of sixty-two children had acute fulminant myocarditis. Four patients died in the acute phase of AM, and 11 developed DCM. Follow up was 27.14±36.52 months. Patients with poor outcome (DCM development) were under the age of seven (odds ratio [OR] 10.1; p=0.003), more likely to be girls (OR 4.6; p=0.03), and had fulminant myocarditis (OR 27.0; <0.001). An ejection fraction (EF) <55% and fractional shortening (FS) <30% increased risk of DCM 13- and 5-fold, respectively, but patients with EF between 40 and 55% remain at highest risk of developing DCM. There was a 12-fold increased risk for DCM in patients with left ventricular end-diastolic diameter Z score >2+. The receiver operator curve showed that the lactate dehydrogenase (LDH) cut-off value for developing DCM was 1780 mmol/l (sensitivity 80%, specificity 100%). ConclusionAcute fulminant myocarditis was an independent risk factor for DCM. Children with EF between 40 and 50% at admission were at highest risk of developing DCM. Lactate dehydrogenase value could be a significant prognostic value for the outcome of pediatric myocarditis. ER -