Ammann Peter, Naegeli Barbara, Schuiki Ernst, Straumann Edwin, Frielingsdorf Jürgen, Rickli Hans, Bertel Osmund
Division of Cardiology, Department of Internal Medicine, Triemli Hospital Zurich, 8063, Zurich, Switzerland.
Int J Cardiol. 2003 Jun;89(2-3):217-22. doi: 10.1016/s0167-5273(02)00478-3.
There are few data concerning prognostic markers of acute myocarditis. The purpose of this study was to assess the prognostic value of initial measurements of creatine kinase (CK), cardiac troponin I (cTnI) and myoglobin as regards late recovery of the left ventricular ejection fraction on follow-up.
A total of 22 patients (53+/-15 years old, 11 female) with acute myocarditis were followed up in a prospective observational study. Of these, 11 (50%) showed a history of acute infection prior to hospitalisation and seven (32%) had pericardial effusion. The median ejection fraction during the acute phase was 47+/-17%; after a mean follow-up of 119+/-163 days it improved to 60+/-9% (P<0.001). Considering maximal CK-rise values of 641+/-961 U/l (P=0.38), cTnI-rise values of 3.7+/-8.6 microg/l (P=0.16) and myoglobin values of 7.4+/-12 nmol/l (P=0.69), there was no correlation between initial cardiac enzyme levels and the initial and late left ventricular ejection fraction.
After acute myocarditis, there is late recovery of left ventricular ejection fraction, which is independent of the initial myocardial damage measured by cardiac enzyme release.
关于急性心肌炎预后标志物的数据较少。本研究的目的是评估肌酸激酶（CK）、心肌肌钙蛋白I（cTnI）和肌红蛋白的初始测量值对随访时左心室射血分数后期恢复情况的预后价值。
在一项前瞻性观察研究中，对22例急性心肌炎患者（年龄53±15岁，女性11例）进行了随访。其中，11例（50%）在住院前有急性感染史，7例（32%）有心包积液。急性期的中位射血分数为47±17%；平均随访119±163天后，射血分数提高到60±9%（P<0.001）。考虑到CK最大升高值为641±961 U/l（P=0.38），cTnI升高值为3.7±8.6 μg/l（P=0.16），肌红蛋白值为7.4±12 nmol/l（P=0.69），初始心肌酶水平与初始及后期左心室射血分数之间无相关性。
急性心肌炎后，左心室射血分数后期会恢复，且与通过心肌酶释放所测得的初始心肌损伤无关。
