Identifying Non-invasive Tools to Distinguish Acute Myocarditis from Dilated Cardiomyopathy in Children

The objective of this study was to identify patterns of clinical presentation and to assess non-invasive measures to differentiate patients with acute myocarditis from other forms of DCM. We identified all children (<  18 years) from our institution with a diagnosis of idiopathic DCM or myocarditis based on endomyocardial biopsy or explant pathology (1996–2015). Characteristics at the time of presentation were compared between patients with a definite diagnosis of myocarditis and those with idiopathic DCM. D ata collected included clinical and laboratory data, radiography, echocardiography, and cardiac catheterization data. A total of 58 patients were included in the study; 46 (79%) with idiopathic DCM and 12 (21%) with acute myocarditis. Findings favoring a diagnosis of myocarditis included a history o f fever (58 vs. 15%,p = 0.002), arrhythmia (17 vs. 0%,p = 0.003), higher degree of cardiac enzyme elevation, absence of left ventricular dilation (42 vs. 7%,p = 0.002), segmental wall motion abnormalities (58 vs. 13%,p = 0.001), lower left ventricular dimensionz-score (3.7 vs. 5.2,p = 0.031), and less severe depression of left ventricular systolic function. There are notable differences between patients with myocarditis and other forms of DCM that can be detected non-invasively at the time of presentation without the need for endomyocardial biopsy. These data suggest that it may be possible to develop a predictive model to differentiate myocarditis ...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research