0532: Features and outcomes of acute myocarditis in children

This study was to assess features and outcomes of children with acute myocarditis.MethodsPatients <18y with acute myocarditis (proved by virology and/ or MRI and/ or complete recovery of myocardial function) were included. Clinical data, echocardiographic parameters and outcomes were collected and cases divided in groups I (< 2y), II (2 to 10y) and III (>10y).Results72 patients were included (1983 to 2012), 30males, aged 4.1±5.1y (med1.5y): 43 in group I, 17 in II and 12 in III. Heart failure was present at onset in 57(78%): 8 cardiogenic shock (12%), 30 severeHF (44%) were more frequent in I (56%) and II (46%) than in III (17%, p< 0.0001), chest pain (15.5%) was more frequent in III (83%). LVSF at diagnosis was 18.4±9%: 16% and 15% in groups I and II vs 30.5% in III (p= 0.0001). Aortic VTI was 11.4±5.8cm: 8cm and 11 in groups I and II vs 17 in group III (p< 0.05). Mitral regurgitation was present in 76.5%, pericarditis in 16.4%, thromboembolic events occurred in 5(7%), arrhythmias in 7(10%). Virus was found in 27=37.5% (1virus in 24, >in 3). Nine patients died (13%) within 2months post-diagnosis (2days to 8.6months), 1 was transplanted (3rdmonth), 19 have sequellae (27.5%), 40 recovered (58%), at FU= 5.5±5.6y. Inotrope was needed in 34(47%):51%, 59% and 16% of groups I, II and III respectively (p<0.0001). Six (8.3%, 1 in groupIII) needed mechanical circulatory support (3ECMO, 3VAD), within day-14 from onset: 1 died on support, 5 were weaned-off (duration of support: 4d to 3mos). Survival was 96%, 90%, 87.5% and 86% at 1, 3 and 6months, 2y and 10y of FU. All patients in III survived. Ten-yr survival was 81.4% in I, 88.2% in II (p= NS). LVSF improved from 18.4±8.9% at onset, to 24.6±10.3% at 1stmth, 26.5±8.6% at 3rdmth, 30.7±8.6% at 6thmth, 38±7% at last FU.Abstract 0254 - Figure: Increase in HMDP heart retention after 16months.ConclusionAcute myocarditis in children has favourable outcomes despite early mortality. Myocardial dysfunction and heart failure are less frequent in patients > 10years. Mechanical circulatory support lessens mortality. Myocardial contractility progressively improves within the first 6months after onset