Risk Factors for Patients Developing a Fulminant Course With Acute Myocarditis
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概要
- 論文の詳細を見る
Background A fulminant course can be difficult to predict at the onset of acute myocarditis, so the aim of the present study was to identify the predictive clinical symptoms/signs or laboratory findings. Methods and Results Thirty-nine patients with acute lymphocytic myocarditis, excluding 8 who manifested shock at admission, were studied. The fulminant group was defined as 12 patients who developed shock after admission, requiring intraaortic balloon pumping or percutaneous cardiopulmonary support, and the non-fulminant group comprised the 27 patients without shock. Various parameters at admission were compared between the 2 groups, together with multiple logistic regression analysis, excluding 6 patients with partially missing values. In the fulminant group, C-reactive protein (7.0±7.0 vs 2.3±2.2mg/dl, p<0.01) and creatine kinase(1,147±876 vs 594±568 IU/L, p<0.05) concentrations were higher, intraventricular conduction disturbances were more frequent (9/12 vs 7/27 patients, p<0.01) and the left ventricular ejection fraction was lower (40.7±13.9 vs 50. 1±10.6%, p<0.05) than in the non-fulminant group. In the multiple logistic regression analysis model with the presence/absence of a fulminant course considered as the independent variable, and C-reactive protein, creatine kinase, intraventricular conduction disturbances, and left ventricular ejection fraction as dependent variables, a high-risk group (expected proportion of fulminant course ≥0.5) and a low-risk group (<0.5) could be differentiated. A fulminant course occurred in 9/13 (69%) patients in the high-risk group, but in only 2/20 (10%) patients in the low risk group (p<0.001). Conclusions The risk of a fulminant course of acute myocarditis was high in patients with elevated C-reactive protein, and creatine kinase concentrations, decreased left ventricular ejection fraction, and intraventricular conduction disturbances at the time of admission.
- 社団法人日本循環器学会の論文
- 2004-07-20
著者
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HASHIMOTO Shuji
Department of Physiologic Laboratory, National Cardiovascular Center
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HISHIDA Hitoshi
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine
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Morimoto Shin-Ichiro
Division of Cardiology, Department of Medicine, Fujita Health University School of Medicine
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MIYAGISHIMA Kenji
Division of Cardiology, Department of Internal Medicine, Fujita Health University, School of Medicin
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KATO Yasuchika
Division of Cardiology, Department of Internal Medicine, Fujita Health University, School of Medicin
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Hishida Hitoshi
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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Uemura Akihisa
Fujita Ezetimibe Study Assembly (festa)
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Morimoto Shin-ichiro
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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Mori Shin
Department Of Internal Medicine Fujita Health University School Of Medicine
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Ohtsuki Masatsugu
Department of Cardiology, Fujita Health University School of Medicine
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Mori Shin
Saitama Medical Center Jichi Medical University
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Hishida H
Department Of Cardiology Fujita Health University
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Yoshida Yukihiko
Cardiovascular Center, Nagoya Dai-ni Red Cross Hospital
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Morimoto Shin-ichiro
First Department Of Internal Medicine Shinshu University
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Morimoto Shin-ichiro
Saitama Medical Center Jichi Medical University
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Hiramitsu Shinya
Division of Cardiology, Fujita Health University
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Uemura Akihisa
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine
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Ohtsuki Masatsugu
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine
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Kato Shigeru
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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Yamada K
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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Miyagishima Kenji
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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Ohtsuki Masatsugu
Department Of Cardiology Fujita Health University School Of Medicine
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Ohtsuki Masatsugu
Department Of Pharmacology Fujita Health University School Of Medicine
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Ohtsuki Masatsugu
Departments Of Pharmacology Fujita Health University
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Morimoto Shin-ichiro
Department Of Pathology Tokyo Women's Medical College
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Usui Akihiko
Cardiothoracic Surgery Nagoya University Graduate School Of Medicine
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Ohtsuki Masatsugu
藤田保健衛生大学 内科学
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Hiramitsu Shinya
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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Hashimoto Shuji
Department Of Applied Biological Chemistry Faculty Of Agriculture Niigata University
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Sekiguchi Morie
Dept. Of Cardiovascular Surqery The Heart Institute Of Japan Tokyo Women's Medical College
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Yoshida Yukihiko
Cardiovascular Center Nagoya Daini Red Cross Hospital
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Kato Yasuchika
Division Of Cardiology Department Of Internal Medicine Fujita Health University School Of Medicine
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