A New Scoring System to Predict the Efficacy of Steroid Therapy for Patients With Active Myocarditis : A Retrospective Study

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概要

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• The efficacy of steroid therapy for active myocarditis is controversial, so a new scoring system was constructed based on 6 clinical parameters : (1)the mode of onset of the disease ; (2)complications of immune-related systemic disorders ; (3)evidence of viral infection ; (4)the population of infiltrating inflammatory cells ; (5)the appearance of multinucleated giant cells in endomyocardial biopsy specimens ; and(6)the duration of active myocarditis. Points from -2 to +2 were assigned to each parameter and the total score was calculated from the 6 parameters. Twenty-one patients with clinically suspected myocarditis, who had been admitted to hospital from 1987, were retrospectively analyzed by this scoring system. Sixteen patients were treated without corticosteroids at presentation, and 5 patients were treated by conventional methods with adjunctive use of corticosteroids. In 10 patients of the non-steroid group myocarditis improved and their mean score was -4.8 at presentation. In 6 patients of the non-steroid group, myocarditis and cardiac symptoms persisted after initial therapy, and their score at presentation was -0.8. In 2 patients of the steroid group myocarditis improved after initial therapy and their score was +2. In 2 other patients of the steroid group, myocarditis and cardiac symptoms persisted and their score was +3. Another patient of the steroid group died from congestive heart failure and his score was -5 at presentation. In 8 of 9 patients with persistent myocarditis, the secondary phase therapy was challenged. Seven patients were treated with corticosteroids and 6 patients improved. Their score at the secondary phase was +2.5. Overall, non-steroid conventional treatment was successful in patients with the scores from -5 to -4, and steroid therapy succeeded in patients with scores from 0 to +6. Although this is a retrospective study, this scoring system is able to predict the efficacy of steroid therapy in patients with clinically suspected active myocarditis.

• 社団法人日本循環器学会の論文
• 1998-09-20

著者

• Izumi Tohru

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Aizawa Yoshifusa

  First Department of Internal Medicine, Niigata University School of Medicine

• Kodama Makoto

  First Department of Internal Medicine, Division of Cardiology, Niigata University School of Medicine

• Izumi T

  Department Of Human Life And Environmental Science Niigata Women's College

• HIRONO Satoru

  First Department of Internal Medicine, Niigata University School of Medicine

• Ohkura Yuji

  新潟大学 医歯学総合研究科循環器学分野

• Izumi Tohru

  The First Department Of Internal Medicine Niigata University School Of Medicine

• Hirono Satoru

  First Department Of Medicine Niigata University School Of Medicine

• Sato Hironori

  1st Dept. Of Med. Niigata Univ. School Of Med.

• Hanawa H

  Division Of Cardiology Niigata University Graduate School Of Medical And Dental Sciences

• Hanawa Haruo

  First Dept of Internal Medicine

• Okura Yuji

  First Department of Internal Medicine, Niigata University School of Medicine

• OGAWA Yusuke

  First Department of Medicine, Niigata University School of Medicine

• Izumi Tohru

  Department Of Internal Medicine Kitasato University School Of Medicine

• Ogawa Yusuke

  First Department Of Medicine Niigata University School Of Medicine

• Itoh Masahiro

  First Department of Internal Medicine, Niigata University School of Medicine

• Hirono Satoru

  Division Of Cardiology Niigata University School Of Medical And Dental Sciences

• Aizawa Yoshifusa

  First Department Of Internal Medicine Niigata Universaity School Of Medicine

• Izumi Tohru

  Department Of Cardio-angiology Kitasato University School Of Medcine

• Kodama Makoto

  First Dep. Of Medicine Graduate School Of Medical And Dental Sciences Niigata Univ.

• Izumi Tohru

  The First Department Of Internal Medicine

• Izumi Tohru

  Department Of Angio-cardiology Kitasato University School Of Medicine

• HANAWA Haruo

  First Department of Internal Medicine, Niigata University

• HIRONO Satoru

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

• AIZAWA Yoshifusa

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

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