Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry “MYKKE”
Corresponding Author
Stephan Schubert
Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
DZHK (German Centre for Cardiovascular Research), Berlin, Germany
Correspondence
Stephan Schubert, Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Email:[email protected]
Search for more papers by this authorBernd Opgen-Rhein
Department for Pediatric Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Search for more papers by this authorMartin Boehne
Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
Search for more papers by this authorAnnika Weigelt
Department for Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany
Search for more papers by this authorRobert Wagner
Department for Pediatric Cardiology, Herzzentrum Leipzig, Leipzig, Germany
Search for more papers by this authorGötz Müller
Department for Pediatric Cardiology, Universitäres Herzzentrum Hamburg, Hamburg, Germany
Search for more papers by this authorAxel Rentzsch
Department for Pediatric Cardiology, Universitätsklinikum des Saarlandes, Homburg, Germany
Search for more papers by this authorEdzard zu Knyphausen
Department for Pediatric Cardiology, Herz- und Diabetes-zentrum NRW, Bad Oeynhausen, Germany
Search for more papers by this authorMarcus Fischer
Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig Maximilians University of Munich, Munich, Germany
Search for more papers by this authorKonstantin Papakostas
Department for Pediatric Cardiology, Klinikum Links der Weser, Bremen, Germany
Search for more papers by this authorGesa Wiegand
Department for Pediatric Cardiology, University Hospital Tübingen, Tübingen, Germany
Search for more papers by this authorBettina Ruf
Department for Pediatric Cardiology, Deutsches Herzzentrum München, München, Germany
Search for more papers by this authorTobias Hannes
Department for Pediatric Cardiology, University Hospital Köln, Köln, Germany
Search for more papers by this authorKatja Reineker
Department for Pediatric Cardiology, Universitäts-Herzzentrum Freiburg Bad Krozingen, Freiburg, Germany
Search for more papers by this authorDaniela Kiski
Department for Pediatric Cardiology, University Hospital Münster, Münster, Germany
Search for more papers by this authorMarkus Khalil
Department for Pediatric Cardiology, University Hospital Gießen, Giessen, Germany
Search for more papers by this authorMichael Steinmetz
Department for Pediatric Cardiology, Universitätsmedizin Göttingen, Göttingen, Germany
Search for more papers by this authorGunther Fischer
Department for Pediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Germany
Search for more papers by this authorThomas Pickardt
Kompetenznetz Angeborene Herzfehler, Berlin, Germany
Search for more papers by this authorKarin Klingel
Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany
Search for more papers by this authorDaniel R. Messroghli
DZHK (German Centre for Cardiovascular Research), Berlin, Germany
Department for Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Department for Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Search for more papers by this authorFranziska Degener
Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
DZHK (German Centre for Cardiovascular Research), Berlin, Germany
Institute for Cardiovascular Computer-assisted Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
Search for more papers by this authorthe MYKKE consortium
Search for more papers by this authorCorresponding Author
Stephan Schubert
Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
DZHK (German Centre for Cardiovascular Research), Berlin, Germany
Correspondence
Stephan Schubert, Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Email:[email protected]
Search for more papers by this authorBernd Opgen-Rhein
Department for Pediatric Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Search for more papers by this authorMartin Boehne
Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany
Search for more papers by this authorAnnika Weigelt
Department for Pediatric Cardiology, University Hospital Erlangen, Erlangen, Germany
Search for more papers by this authorRobert Wagner
Department for Pediatric Cardiology, Herzzentrum Leipzig, Leipzig, Germany
Search for more papers by this authorGötz Müller
Department for Pediatric Cardiology, Universitäres Herzzentrum Hamburg, Hamburg, Germany
Search for more papers by this authorAxel Rentzsch
Department for Pediatric Cardiology, Universitätsklinikum des Saarlandes, Homburg, Germany
Search for more papers by this authorEdzard zu Knyphausen
Department for Pediatric Cardiology, Herz- und Diabetes-zentrum NRW, Bad Oeynhausen, Germany
Search for more papers by this authorMarcus Fischer
Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig Maximilians University of Munich, Munich, Germany
Search for more papers by this authorKonstantin Papakostas
Department for Pediatric Cardiology, Klinikum Links der Weser, Bremen, Germany
Search for more papers by this authorGesa Wiegand
Department for Pediatric Cardiology, University Hospital Tübingen, Tübingen, Germany
Search for more papers by this authorBettina Ruf
Department for Pediatric Cardiology, Deutsches Herzzentrum München, München, Germany
Search for more papers by this authorTobias Hannes
Department for Pediatric Cardiology, University Hospital Köln, Köln, Germany
Search for more papers by this authorKatja Reineker
Department for Pediatric Cardiology, Universitäts-Herzzentrum Freiburg Bad Krozingen, Freiburg, Germany
Search for more papers by this authorDaniela Kiski
Department for Pediatric Cardiology, University Hospital Münster, Münster, Germany
Search for more papers by this authorMarkus Khalil
Department for Pediatric Cardiology, University Hospital Gießen, Giessen, Germany
Search for more papers by this authorMichael Steinmetz
Department for Pediatric Cardiology, Universitätsmedizin Göttingen, Göttingen, Germany
Search for more papers by this authorGunther Fischer
Department for Pediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Germany
Search for more papers by this authorThomas Pickardt
Kompetenznetz Angeborene Herzfehler, Berlin, Germany
Search for more papers by this authorKarin Klingel
Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany
Search for more papers by this authorDaniel R. Messroghli
DZHK (German Centre for Cardiovascular Research), Berlin, Germany
Department for Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Department for Cardiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Search for more papers by this authorFranziska Degener
Department of Congenital Heart Disease - Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
DZHK (German Centre for Cardiovascular Research), Berlin, Germany
Institute for Cardiovascular Computer-assisted Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
Search for more papers by this authorthe MYKKE consortium
Search for more papers by this authorAbstract
Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failure and myocarditis is unclear. The aim of this study was to determine characteristics and outcome of patients with severe heart failure requiring MCS and/or heart transplantation. The MYKKE cohort between September 2013 and 2016 was analyzed. A total of 195 patients were prospectively enrolled by 17 German hospitals. Twenty-eight patients (14%) received MCS (median 1.5 years), more frequently in the youngest age group (0-2 years) than in the older groups (P < 0.001; 2-12 and 13-18 years). In the MCS group, 50% received a VAD, 36% ECMO, and 14% both, with a survival rate of 79%. The weaning rate was 43% (12/28). Nine (32%) patients were transplanted, one had ongoing support, and six (21%) died. Histology was positive for myocarditis in 63% of the MCS group. Patients within the whole cohort with age <2 years and/or ejection fraction <30% had a significantly worse survival with high risk for MCS, transplantation, and death (P < 0.001). Myocarditis represents a life-threatening disease with an overall mortality of 4.6% in this cohort. The fulminant form more often affected the youngest, leading to significantly higher rate of MCS, transplantation, and mortality. MCS represents an important and life-saving therapeutic option in children with myocarditis with a weaning rate of 43%.
CONFLICT OF INTEREST
None.
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