On influencing factors of severe viral myocarditis in adults

Abstract:

Objective：To investigate the clinical features and the influencing factors of severe viral myocarditis（SVM） in adult patients. Methods：A retrospective analysis was conducted in 93 cases of acute viral myocarditis diagnosed in our hospital from July 2015 to December 2019. These patients were divided into SVM group（n=45），and common viral myocarditis（CVM） group（n=48） according to the severity of the disease. Clinical general baseline characteristics，the parameters of electrocardiogram，laboratory and echocardiogram in the two groups were compared and analyzed to explore the influencing factors. Results：Compared with the CVM group，the systolic blood pressure and left ventricular ejection fraction were decreased，ALT，troponin Ⅰ，myoglobin，QRS duration，left ventricular end systolic diameter were increased，and the proportions of ST-segment elevation myocardial injury，low voltage，dyspnea，syncope，and shock were increased in the SVM group. Multivariate logistic regression analysis showed that ST-segment elevation myocardial injury（OR=28.224，95%CI=1.043-763.543，P=0.047） and troponin Ⅰ（OR=1.321，95%CI=1.059-1.647，P=0.013） were associated with increased risk of the onset of SVM，and the systolic blood pressure（OR=0.892，95%CI=0.805-0.988，P=0.028） was associated with decreased risk of the onset of SVM. Conclusion：ST-segment elevation myocardial injury and troponin Ⅰ may be the independent risk factors of adult patients with SVM，and systolic blood pressure may be an independent protective factor.