Author + information
- Massimo Imazio,
- Antonio Brucato,
- Andrea Barbieri,
- Francesca Ferroni,
- Federica Bonomi,
- Francesca Mantovani,
- Alessandra Chinaglia,
- Paola Di Corato,
- Roberta Lugli,
- Paola Valenti,
- Giovanni Della Casa and
- Riccardo Belli
The natural history of myopericarditis/perimyocarditis is poorly known and recently published data have presented contrasting results on their outcomes. The aim of the present article is to assess their prognosis in a multicenter, prospective cohort study.
A total of 486 patients (median age 39 years, range 18-83, 300 men) with acute pericarditis or a myopericardial inflammatory syndrome (myopericarditis/perimyocarditis) (85% idiopathic, 10% autoimmune, and 5% infective) were prospectively evaluated from January 2007 to December 2011. Consecutive cases were recruited in 3 urban referral medical centres (Maria Vittoria Hospital, Torino, Ospedali Riuniti, Bergamo, and Policlinico, Modena, Italy). The diagnosis of acute pericarditis was based on the presence of 2 of 4 clinical criteria (chest pain, pericardial rubs, widespread ST-segment elevation or PR depression, and new or worsening pericardial effusion). Myopericardial inflammatory involvement was suspected with cardiac troponin elevation and/or new or worsening ventricular dysfunction on echocardiography, and confirmed by cardiac magnetic resonance.
After a median follow-up of 36 months (range 6-66), normalization of LV function was achieved in 90% of patients with myopericarditis/perimyocarditis. No deaths were recorded, as well as evolution to heart failure or symptomatic LV dysfunction. Recurrences were the most common complications during follow-up and were more frequently recorded in patients with acute pericarditis (32%) than myopericarditis (11%) or perimyocarditis (12%;p<0.001). On multivariable analysis, pericardial effusion at presentation (HR 2.2) and corticosteroid therapy (HR 6.7) were risk factors for recurrences.
The outcome of myopericardial inflammatory syndromes is benign. Unlike acute coronary syndromes, troponin elevation is not a negative prognostic marker in this setting.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pericardial Diseases
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 1250-143
- 2013 American College of Cardiology Foundation