Beschreibung:
Aim:Althougha fulminant course of the myocarditis is difficult to predict, it may lead toacute heart failure and death. Previous studies have demonstrated that reducedleft ventricular systolic function and prolonged QRS duration can predict thefulminant course. This study aimed to identify whether fragmented QRS complex(fQRS) could also be predictive of fulminant disease in this population. Material and Methods: We retrospectively included 156 patients diagnosed with acutemyocarditis. They were divided into the fulminant group (n = 18) and thenon-fulminant group (n = 138). Multivariate logistic regression analysis wasused to identify the independent factors predictive of fulminant disease. Results: FragmentedQRS developed in 11 (61%) in the fulminant group and only 10 patients (7%) inthe non-fulminant group (p <0.001). Patients with fulminant myocarditis had a higher mortality ratethan those with non-fulminant disease (44.6% vs. 0%, p < 0.001).Multivariate analysis revealed that the presence of fQRS (p=0.019), longerTpe/qt ratio (p=0.022) and clinical heart failure (<0.001) were significant predictors associated with a fulminant courseof myocarditis. Conclusion:The presence of fQRS complex, as a simple and feasibleelectrocardiographic marker, seems to be a novel predictor fulminantmyocarditis. Thissimpleparameter may be used in identifying patients at high risk for fulminancyand so early mechanical support could provideimproved patient outcomes.