Influence of Age and Gender on Myocarditis in Pediatric Patients
The German multi-centre registry MYKKE presents initial data analysis on the impact of age and gender on the incidence, severity, and clinical course of myocarditis in pediatric patients. The study includes data on symptoms at admission, diagnostics, ejection fraction according to age groups, and more. This research highlights the importance of considering age and gender in the management of pediatric myocarditis.
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Presentation Transcript
Myocarditis in paediatric patients: age and gender are influencing incidence, severity and clinical course. Initial data analysis from the German multi-centre registry MYKKE Franziska Degener 46th Congress SICP Parma, 05.11.2016
Registry for children and adolescents with suspected myocarditis multi-center prospective pseudonymised Inclusion criteria: suspected myocarditis hospital admission age <18 years informed consent 2 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Participating centers 3 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Included patients (n=207) 45 40 40 35 Number of patients 30 25 22 21 20 20 17 16 15 12 10 10 9 10 6 6 6 6 5 3 1 1 1 0 4 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Age at symptom onset (n=207) 45 40 35 7 17 30 Number of patients 25 4 20 7 9 15 30 24 23 10 5 15 4 5 11 5 2 1 3 0 6 1 1 4 2 0 4 4 1 3 3 2 1 0 4 2 2 2 1 2 1 7 0 0 1 3 5 6 8 9 10 11 12 13 14 15 16 17 Age in years male female 5 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Gender(n=207) 33% 67% male female 6 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Symptoms at admission (n=207) Sudden cardiac death 2.9 Others 11.7 Syncope 13.1 Feeding intolerance 21.8 Arrhythmia 30.6 Fever <6 weeks prior symptom onset 35.0 Angina pectoris 37.9 Dyspnea 38.8 Infection <6 weeks prior symptom onset 55.8 Exercise intolerance 72.3 0 10 20 30 40 % 50 60 70 80 7 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Diagnostics (n=207) 99 99 98 100 96 96 100 79 80 65 60 52 51 51 50 50 % 40 20 15 0 8 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Ejection fraction according age groups (n=207) 60 55 51 50 39 40 EF <30% EF 30-44% EF 45-54% EF 55% 32 30 % 23 20 18 20 14 13 10 9 10 7 0 0-<2 years 2-12 years 13-18 years 9 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Adverse Events according age groups (n=207) 0-<2 years (n=49) 2-12 years (n=41) 13-18 years (n=117) 60 53 50 41 40 30 % 20 20 20 17 16 15 13 10 10 10 9 10 7 7 7 6 5 5 4 4 4 3 2 2 2 2 2 1 1 1 0 0 0 0 10 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Therapy (n=206) 100 92 80 59 60 % 40 33 30 27 27 25 20 6 2 0 0 11 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Follow up EF in Echo (n=38) Median Follow up 11 month p<0.001 EF in % 12 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Conclusion MYKKE is a successful multicenter registry for myocarditis in children and adolescents Data underline two age peaks (0-<2 years and 13-18 years) Severe clinical course and more adverse events are present in young children Overall mortality of 3.9% MYKKE serves as a platform for deriving diagnostic criteria and in future interventional studies 13 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Outlook End of 2016 Diagnostic criteria and a diagnostic score 2017 Standardized diagnostic in pediatric patients in Germany 2017-2018 Including another 150 patients Validation of diagnostic criteria / score 2018 Data on Outcome in children and adolescents with myocarditis Genetic / immunological analyses for understanding different pathomechanisms 2018 multi-center interventional therapy studies on myocarditis in children Participating international centers 14 DHZB | MYKKE: Initial data analysis | Parma 05.11.2016
Thank you. Deutsches Herzzentrum Berlin Stiftung des b rgerlichen Rechts Augustenburger Platz 1 13353 Berlin Telefon: +49 30 4593-1000 Telefax: +49 30 4593-1003 E-Mail: info@dhzb.de www.dhzb.de
