Abstract
Aim: The pathogenesis of myocarditis, which has high morbidity and mortality in childhood and adolescence, has not been fully elucidated. The pathogenesis of acute myocarditis is a complex process in which multiple agents play a role. We aimed to compare ECG, laboratory and echocardiographic parameters of patients during acute exacerbation of myocarditis and clinical remission. Material and Method: 144 patients (124 males, 20 females) with an acute myocarditis episode were included in the study (28 ± 5). These patients were called for control during the clinical remission period of 3-12 months. The ECG, laboratory and echocardiographic parameters of the patients were compared during acute exacerbation and clinical remission. QT and Tp-e ECG parameters were measured. In addition to routine biochemistry and hemogram parameters, troponin I, uric acid, CRP, sedimentation, TSH and cholesterol levels were measured. Left ventricular ejection fraction was measured as an echocardiographic parameter. Results: When compared with the clinical remission Tp-e interval (p: 0.032), QT-max (p=0.014), QT-min (p=0.001), TSH (p<0.001), Trop (p<0.00), Urea (p=0.028), Alt (p=0.010), Ast (p<0.001), Wbc (p<0.001), Hb (p<0.001), Htc (p<0.001), Rdw (p<0.001), Plt (p<0.001), Mpv (p<0.001), Neu (p=0.003), Lym (p=0.013), Mon (p<0.001), Eo (p=0.003), Pdw (p<0.001), CRP (p=0.001), ESR (p<0.001), and HDL-C (p=0.002) were significantly changed in patients with acute attack myocarditis. Conclusion: ECG parameters, inflammation markers, and HDL cholesterol levels were significantly improved in the clinical remission in addition to the left ventricular ejection fraction during acute exacerbation of the patients. LVEF, ECG parameters, inflammation markers, TSH and HDL cholesterol levels were thought to be important in terms of clinical course and pathogenesis of the disease.
Highlights
Myocarditis is an inflammation of the myocardium, which is the heart muscle
We detected that ECG parameters (Tp-e, QTmax, QT-min), hemogram parameters (Wbc, Hb, Htc, Rdw, Plt, Mpv, Neu, Lym, Mon, Eo, Pdw), biochemical parameters (Tsh, Uric acid, Troponin, Alt, Ast, ESR, HDL-C) and echocardiographic parameters (EF) significantly found in acute attack myocarditis
As far as we know in the literature, ECG, laboratory, and echo parameters were investigated in patients with myocarditis, no acute attack and clinical remission comparison studies have been performed
Summary
Myocarditis is an inflammation of the myocardium, which is the heart muscle. Acute myocarditis is often caused by viral diseases, but less commonly it can be caused by noninfectious etiologies [1]. The incidence of myocarditis varies between 1% and 9% in postmortem examinations [2]. Its clinical presentation is very variable and can range from thin chest pain or fever to life-threatening congestive heart failure or even sudden cardiac death. While the classical myocarditis patient presents with a preceding viral illness followed by heart failure symptoms, clinical presentations range from mild chest pain with normal systolic function to cardiogenic shock and electrophysiological disturbances [35]. It is difficult to diagnose and treatment is usually supportive [6]
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