JCK-AP session 2 (II-JCKAP2)
Kawasaki disease / General Cardiology

[II-JCKAP2-6] Risk factors for cardiac death of acute myocarditis in children

^○Geena Kim^1,2, Aamir Jeewa², Dawn Nicolson², Sunghoon Minn² (1.Department of Pediatrics, Chungnam National University Sejong Hospital, Sejong / Chungnam National University School of Medicine, Daejeon, 2.Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto)

キーワード：Acute myocarditis, Children, cardiac death

A retrospective review of patients with acute myocarditis at single hospital between January 2001 and December, 2021, was conducted. There were 56 patients of definite and possible clinical acute myocarditis, including 12 cardiac death (9 heart transplantation, 3 death). Cardiac death rate was 21.4 %. We divided 2 groups with or without cardiac death and compared clinical characteristics, laboratory and echocardiographic data, treatment. Median age was 3.5 years and median length to admission was 10 days. The mean value of initial left ventricular ejection fraction (LVEF) of cardiac death group was 20.8 % (2SD; 9.7 %) that was significantly lower than 40.8 % (2SD; 15.2 %) of no cardiac death group (P<0.001). In initial left ventricular end diastolic diameter z-score, cardiac death group was much higher than no cardiac death group (Mean ± 2 standard deviation, 3.32 ± 1.94, 1.61 ± 1.68, respectively) (P=0.008). Cardiopulmonary resuscitation, any mechanical circulatory support and heart transplantation listing were performed in 19 patients (33 %) in total patients, 11 patients of cardiac death group was performed much higher (P<0.001). In multivariable analysis of predictors of cardiac death, initial low LVEF was independent risk factor (95% CI 0.814-0.968, P=0.007). The cutoff value of LVEF that predicted cardiac death was 30.5 % showing sensitivity of 90.9% and specificity of 75.6% (P<0.001). Patients with initial low LVEF independently showed poor outcome with cardiac death in children with acute myocarditis.