Thorac cardiovasc Surg 2017; 65(S 02): S111-S142
DOI: 10.1055/s-0037-1599006
DGPK Oral Presentations
Monday, February 13th, 2017
DGPK: Miscellaneous
Georg Thieme Verlag KG Stuttgart · New York

Update on Baseline Data and First 1-Year Follow-up of the German Multicenter Myocarditis Registry for Pediatric Patients: “MYKKE”

F. Degener
1  Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany
,
B. Opgen-Rhein
2  Charité Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Kardiologie, Berlin, Germany
,
F. Schmidt
4  Medizinische Hochschule Hannover, Kinderkardiologie, Hannover, Germany
,
A. Weigelt
5  Universitätsklinikum Erlangen, Kinderkardiologie, Erlangen, Germany
,
R. Wagner
6  Herzzentrum Leipzig, Kinderkardiologie, Leipzig, Germany
,
G. Müller
7  Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
A. Rentzsch
8  Universitätsklinikum des Saarlandes, Kinderkardiologie, Hombrg/Saar, Germany
,
A. Racolta
9  Herz- und Diabeteszentrum NRW, Zentrum für angeborene Herzfehler, Bad Oeynhausen, Germany
,
K. Papakostas
10  Klinikum Links der Weser, Strukturelle und angeborene Herzfehler / Kinderkardiologie, Bremen, Germany
,
G. Wiegand
11  Universitätsklinikum Tübingen, Klinik für Kinder- und Jugendmedizin, Kinderkardiologie, Tübingen, Germany
,
B. Ruf
12  Deutsches Herzzentrum München, Technische Universität München, Angeborene Herzfehler/Kinderkardiologie, München, Germany
,
T. Hannes
13  Uniklinik Köln, Kinderkardiologie, Köln, Germany
,
K. Reineker
14  Universitäts-Herzzentrum Freiburg Bad Krozingen, Klinik für angeborene Herzfehler und Pädiatrische Kardiologie, Freiburg, Germany
,
D. Kiski
15  Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin/Pädiatrische Kardiologie, Münster, Germany
,
M. Khalil
16  Universitätsklinik Gießen, Abteilung für Kinderkardiologie, Giessen, Germany
,
M. Steinmetz
17  Universitätsmedizin Göttingen, Kinderherzklinik, Klinik für Pädiatrische Kardiologie und Intensivmedizin, Göttingen, Germany
,
G. Fischer
18  Universitätsklinikum Schleswig-Holstein, Klinik für angeborene Herzfehler und Kinderkardiologie, Kiel, Germany
,
T. Pickardt
19  Kompetenznetz Angeborene Herzfehler, Berlin, Germany
,
D. Messroghli
1  Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany
,
S. Schubert
1  Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
02 February 2017 (online)

 
 

    Objectives: There are only few data on epidemiology, diagnosis and therapy of myocarditis in children and adolescents. Our first data revealed a high incidence of young children with severe heart failure, maybe due to immunological differences. With our new data we confirm the first baseline data on age-related clinical differences in this patient group and show for the first time follow up data.

    Methods: After an initial 6-month pilot phase, MYKKE was opened in June 2014 as a prospective multicenter registry for patients from pediatric heart centers, university hospitals, and community hospitals in Germany. The German Competence Network for Congenital Heart Disease provides administrative and logistic support. Inclusion criteria include age < 18 years, hospitalization for suspected myocarditis and written consent. Ethical approval was obtained by local authorities of all collaborating centers.

    Results: By August 4, 2016, a total of 17 centers across Germany are actively participating and have enrolled 193 patients. Baseline data show clear trends for age: 0-< 2 years (45/193; 23%), 2–12 years (36/193; 19%) and 13–18 years (112/193; 58%); gender: male (130/193) 67% of cases. Decrease of exercise capacity (72%) was the leading symptom, followed by angina (38%), dyspnea (38%), arrhythmia (30%) and syncope (14%). Sudden cardiac death was only rare (2%). 55% had an infection less than 6 weeks ago, respectively 35% fever. Patients 0-< 2 years had again the highest incidence of reduction of ejection fraction (EF) below 30% (25/46; 56%) compared with age groups 2–12 years (43%) and 13–18 years (9%). Furthermore they had the highest need for VAD therapy (10/45, 22%) according to 53% patients with acute heart failure. Most children died in the 2–12 years group (4/36; 11%). The overall mortality is 3.6% (7/193). By now we have the follow up data of 45 patients (45/193; 23%) with a mean time of 10 ± 5 month after the first visit. The mean EF was 46 ± 19.7% at initial presentation, which increased to 60 ± 13.8% at follow up.

    Conclusion: With its ongoing enrollment, MYKKE is a successful multi-center registry for myocarditis in children and adolescents. The data underline two age peaks with a severe clinical course and more adverse events in the youngest patients. MYKKE serves as a platform for deriving diagnostic criteria and will later facilitate interventional studies.


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    No conflict of interest has been declared by the author(s).