A large European study led by University Hospital Bonn (UKB) has revealed important new findings about severe myocarditis—an inflammation of the heart muscle that can result in life-threatening complications.
Conducted across 26 centers and involving 271 patients, the study is one of the largest of its kind and was recently published in the European Heart Journal.
Myocarditis can impair the heart’s ability to pump blood effectively. In its most severe form—fulminant myocarditis—the condition can lead to circulatory collapse and cardiac arrest.
Around 30% of cases follow this dangerous path, but until now, little was known about risk factors or long-term outcomes.
The new research, led by Prof. Dr. Dr. med. Enzo Lüsebrink at UKB’s Heart Center, sheds light on prognosis, risk factors, and potential treatment strategies.
One major finding is that patients with a rare form called giant cell myocarditis face a much higher risk of death (50%) compared to other forms (around 30%). This highlights the need for early tissue sampling to confirm diagnosis and guide treatment.
The study also found that age and blood pH level at diagnosis were strong indicators of hospital mortality risk. These findings can help doctors better assess which patients are at higher risk and make faster decisions about using advanced heart support systems.
Encouragingly, the long-term outcomes for survivors were excellent. Among patients who survived to hospital discharge, heart function recovered in most cases, and few additional deaths occurred in the years that followed. Most also retained good neurological function.
“These results underline how crucial it is to quickly identify high-risk patients,” said study lead Lüsebrink. “With age, pH value, and tissue analysis, we now have clearer markers for prognosis.”
Prof. Dr. Georg Nickenig, cardiologist and director of the UKB Heart Center, added, “Endomyocardial biopsy should be done early in suspected cases. The tissue results are essential for guiding treatment decisions and improving outcomes.”
Overall, the study emphasizes that while fulminant myocarditis is dangerous, rapid diagnosis and targeted therapy can dramatically improve survival and recovery.
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The study is published in European Heart Journal.
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