Cantarutti Nicoletta, Battista Virginia, Stagnaro Nicola, Labate Marianna Eleonora, Cicenia Marianna, Campisi Marta, Vitali Valerio, Secinaro Aurelio, Campana Andrea, Trocchio Gianluca, Drago Fabrizio
Cardiology and Arrhythmias Complex Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, 00163 Rome, Italy.
Radiology Unit, IRCCS Istituto Giannina Gaslini, 16132 Genoa, Italy.
Biology (Basel). 2022 Oct 8;11(10):1474. doi: 10.3390/biology11101474.
MIS-C is a multisystem inflammatory syndrome that is characterized by multi-organ failure and cardiac involvement. The aim of this study was to describe the long-term cardiovascular outcome in a cohort of MIS-C pediatric patients, who were admitted to two Italian Pediatric Referral Centers. Sixty-seven patients (mean age 8.7 ± 4.7 years, male 60%) were included; 65 (97%) of them showed cardiac involvement. All of the patients completed one month of the follow-up, and 47% completed 1 year of it. ECG abnormalities were present in 65% of them, arrhythmias were present in 9% of them during an acute phase and it disappeared at the point of discharge or later. Pericarditis were detected in 66% of them and disappeared after 6 months. Coronaritis was observed in 35% of the children during an acute phase, and there were no more instances at the 1-year point. An LV dysfunction was present in 65% of the patients at the beginning of the study, with them having a full recovery at the point of discharge and thereafter. Elevated values of the NTproBNP and hsTp were initially detected, which progressively decreased and normalized at the points of discharge and FU. The CMR at the point of FU, there was a presence of long-term myocardial scars in 50% of the patients that were tested. No deaths that were caused by MIS-C during the FU were recorded. Cardiac involvement in MIS-C patients is almost the rule, but the patients' clinical course was satisfactory, and no additional events or sequelae were observed apart from there being long-term myocardial scars in 50% of the patients that underwent CMR.
儿童多系统炎症综合征（MIS-C）是一种以多器官功能衰竭和心脏受累为特征的多系统炎症综合征。本研究的目的是描述一组入住两家意大利儿科转诊中心的MIS-C儿科患者的长期心血管结局。纳入67例患者（平均年龄8.7±4.7岁，男性占60%）；其中65例（97%）有心脏受累。所有患者均完成了1个月的随访，47%完成了1年的随访。65%的患者存在心电图异常，急性期9%的患者存在心律失常，出院时或之后消失。66%的患者检测到心包炎，6个月后消失。急性期35%的儿童观察到冠状动脉炎，1年时未再出现。研究开始时65%的患者存在左心室功能障碍，出院时及之后完全恢复。最初检测到NTproBNP和hsTp值升高，出院时和随访时逐渐下降并恢复正常。随访时的心脏磁共振成像（CMR）显示，50%接受检测的患者存在长期心肌瘢痕。随访期间未记录到由MIS-C导致的死亡。MIS-C患者心脏受累几乎是普遍现象，但患者的临床病程令人满意，除50%接受CMR检查的患者存在长期心肌瘢痕外，未观察到其他事件或后遗症。
