Scholarlink

Background <p>Temporary mechanical circulatory support (t-MCS) is increasingly used in fulminant myocarditis (FM), yet long-term outcomes and risk factors remain poorly defined.</p> Methods <p>From the FULLMOON international cohort (419 adults with suspected FM across 36 centers in 15 countries), 295 patients treated with venoarterial extracorporeal membrane oxygenation (V-A ECMO) and/or Impella were analyzed. The primary endpoint was mortality at 1&#xa0;year, heart transplantation (HTx), or left-ventricular assist device (LVAD). Multivariate Cox regression identified predictors of adverse outcomes. A propensity score-weighted analysis assessed outcomes based on timing of endomyocardial biopsy (EMB): early (≤ 2&#xa0;days), delayed (&gt; 2&#xa0;days), or none.</p> Results <p>The median age was 39&#xa0;years (IQR 28–60), and 55% were female. Myocarditis was confirmed in 204 (69%) of the patients via histology or cardiac MRI. Histological data were available for 151 (51%) of the cohort. One-year mortality was 36%, while 44% died or had an HTx or LVAD. Predictors of worse outcomes were giant cell myocarditis, older age, cardiac arrest at ECMO initiation, and delayed EMB. Delayed EMB was consistently associated with higher mortality, HTx, or LVAD compared to early (HR = 1.55; 95% CI 1.23–1.96; <i>p</i> &lt; 0.01) or no EMB (HR = 1.59; 95% CI 1.26–2.01; <i>p</i> &lt; 0.01). However, event-free survival did not differ significantly between early EMB and no EMB (HR = 1.03; 95% CI 0.80–1.32; <i>p</i> = 0.85).</p> Conclusions <p>Despite a relatively young cohort, FM requiring t-MCS is associated with a high 1-year mortality rate. Timely recognition and early referral to specialized ECMO centers before cardiac arrest are critical.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Temporary mechanical support in fulminant myocarditis: prognostic factors and clinical implications from the FULLMOON study

  • 期刊论文

  • 发表日期：

    2026年1月12日

查看全文
  • Matthieu Schmidt,
  • Maharajah Ponnaiah,
  • Florent Huang,
  • Santiago Montero,
  • Victor Raimbault,
  • Darryl Abrams,
  • Guillaume Lebreton,
  • Vincent Pellegrino,
  • Joshua Ihle,
  • Maurizio Bottiroli,
  • Romain Persichini,
  • M. Isabel Barrionuevo-Sánchez,
  • Albert Ariza Solé,
  • Pauline Yeung Ng,
  • Simon Sin Wai Ching,
  • Raj Ayer,
  • Hergen Buscher,
  • Caroline Biendel,
  • Clément Delmas,
  • Rita Ferreira,
  • Roberto Roncon-Albuquerque Jr.,
  • Teresa Lόpez-Sobrino,
  • Jeroen J. H. Bunge,
  • Christoph Fisser,
  • Guillaume Franchineau,
  • Jamie McCanny,
  • Shinichiro Ohshimo,
  • Alessandro Sionis,
  • Francisco José Hernández-Pérez,
  • Eduardo Barge-Caballero,
  • Martin Balik,
  • Henrique Muglia,
  • Sunghoon Park,
  • Dirk W. Donker,
  • Beatriz Porral,
  • Nadia Aïssaoui,
  • Armand Mekontso Dessap,
  • Virginia Burgos,
  • Mathieu Lesouhaitier,
  • Justin Fried,
  • Jae-Seung Jung,
  • Sandra Rosillo,
  • Vincent Scherrer,
  • Saad Nseir,
  • Hadrien Winszewski,
  • Pablo Jorge-Pérez,
  • Antoine Kimmoun,
  • Rodrigo Diaz,
  • Guillaume Hekimian,
  • Enrico Ammirati,
  • Alain Combes,
  • Matthieu Schmidt,
  • Alain Combes,
  • Charles Edouard Luyt,
  • Juliette Chommmeloux,
  • Marc Pineton de Chambrun,
  • Guillaume Hekimian,
  • Victor Raimbault,
  • Guillaume Lebreton,
  • Pascal Leprince,
  • Mathieu Kerneis,
  • Gilles Montalescot,
  • Florent Huang,
  • Guillaume Franchineau,
  • Romain Sonneville,
  • Armand Mekontso Dessap,
  • Keyvan Razazi,
  • Nadia Aissaoui,
  • Clement Delmas,
  • Slimane Belaid,
  • Yoan Lavie-Badie,
  • Caroline Biendel,
  • Mathieu Lesouhaitier,
  • Jean-Marc Tadie,
  • Vincent Scherrer,
  • Saad Nseir,
  • Sebastien Preau,
  • Emmanuel Robin,
  • Mouhamed Moussa,
  • Andre Vincentelli,
  • Hadrien Winszewski,
  • Gilles Capellier,
  • Gael Piton,
  • Francois Belon,
  • Matthieu Besutti,
  • Andrea Perrotti,
  • Antoine Kimmoun,
  • Nicolas Champigneulle,
  • Romain Persichini,
  • Julien Jabot,
  • M. Isabel Barrionuevo-Sanchez,
  • Albert Ariza Sole,
  • Eduardo Barge-Caballero,
  • Paula Blanco-Canosa,
  • Zulaika Grille-Cancela,
  • Beatriz Porral,
  • Sergio Raposeiras,
  • Sandra Rosillo,
  • Esteban Lόpez-de-Sa,
  • Francisco Jose Hernandez-Perez,
  • Javier Segovia-Cubero,
  • Manuel Gomez-Bueno,
  • Cristina Mitroi,
  • Mercedes Rivas-Lasarte,
  • Santiago Montero,
  • Andrea Borrelas,
  • Cosme Garcia-Garcia,
  • Alessandro Sionis,
  • Victor Garcia Hernando,
  • Teresa Lόpez-Sobrino,
  • Rut Andrea Riba,
  • Elena Sandoval,
  • Virginia Burgos,
  • Marta Ruiz Lera,
  • Angela Canteli Alvarez,
  • Cristina Castrillo Bustamante,
  • Natalia Royuela Martinez,
  • Pablo Jorge-Perez Martin,
  • J. Garcia-Gonzalez,
  • Marta M. Martin-Cabeza,
  • Enrico Ammirati,
  • Maurizio Bottiroli,
  • Giacomo Veronese,
  • Valeria Bellin,
  • Dinis Reis Miranda,
  • Jeroen J. H. Bunge,
  • Kadir Caliskan,
  • Dirk W. Donker,
  • Rita Ferreira,
  • Roberto Roncon-Albuquerque,
  • Christoph Fisser,
  • Thomas Mueller,
  • Jamie McCanny,
  • Luigi Camporota,
  • Nicholas Barrett,
  • Martin Balik,
  • Jan Belohlavek,
  • Henrique Muglia,
  • Fabio Silvio Taccone,
  • Darryl Abrams,
  • Alexis Serra,
  • Daniel Brodie,
  • Koji Takeda,
  • Cara Agerstrand,
  • Justin Fried,
  • Vincent Pellegrino,
  • Joshua Ihle,
  • Raj Ayer,
  • Hergen Buscher,
  • Simon Sin Wai Ching,
  • Pauline Yeung Ng,
  • Jae-Seung Jung,
  • Jieon Kim,
  • Hong Ju Shin,
  • Sunghoon Park,
  • Shinichiro Ohshimo,
  • Kazuya Kikutani,
  • Nobuaki Shime,
  • Rodrigo Diaz,
  • Andrea Pena Sanchez

摘要

Background

Temporary mechanical circulatory support (t-MCS) is increasingly used in fulminant myocarditis (FM), yet long-term outcomes and risk factors remain poorly defined.

Methods

From the FULLMOON international cohort (419 adults with suspected FM across 36 centers in 15 countries), 295 patients treated with venoarterial extracorporeal membrane oxygenation (V-A ECMO) and/or Impella were analyzed. The primary endpoint was mortality at 1 year, heart transplantation (HTx), or left-ventricular assist device (LVAD). Multivariate Cox regression identified predictors of adverse outcomes. A propensity score-weighted analysis assessed outcomes based on timing of endomyocardial biopsy (EMB): early (≤ 2 days), delayed (> 2 days), or none.

Results

The median age was 39 years (IQR 28–60), and 55% were female. Myocarditis was confirmed in 204 (69%) of the patients via histology or cardiac MRI. Histological data were available for 151 (51%) of the cohort. One-year mortality was 36%, while 44% died or had an HTx or LVAD. Predictors of worse outcomes were giant cell myocarditis, older age, cardiac arrest at ECMO initiation, and delayed EMB. Delayed EMB was consistently associated with higher mortality, HTx, or LVAD compared to early (HR = 1.55; 95% CI 1.23–1.96; p < 0.01) or no EMB (HR = 1.59; 95% CI 1.26–2.01; p < 0.01). However, event-free survival did not differ significantly between early EMB and no EMB (HR = 1.03; 95% CI 0.80–1.32; p = 0.85).

Conclusions

Despite a relatively young cohort, FM requiring t-MCS is associated with a high 1-year mortality rate. Timely recognition and early referral to specialized ECMO centers before cardiac arrest are critical.