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Gender effects on acute myocarditis: are there any differences on myocardial involvement?
Session:
Posters 1 - Écran 10 - Miocárdio e Pericárdio
Speaker:
Leonor Marques
Congress:
CPC 2018
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Leonor Marques; Daniel Seabra De Carvalho; Ana Leal Neto; Henrique Guedes; Aurora Andrade; Paula Pinto
Abstract
<p><strong>Introduction: </strong>Myocarditis constitutes a heterogeneous group of diseases, with different aetiologies and different clinical courses. Fatal acute myocardial inflammation has been linked to younger age and male gender. Whether there are gender differences in the pattern of myocardial involvement is not well understood.</p> <p><strong>Aims: </strong>Characterize a cohort of patients (pts) admitted with a clinically diagnosis of acute myocarditis, who underwent cardiac magnetic ressonance (CMR) and identify analytical, electrical and imaging differences between genders.</p> <p><strong>Methods: </strong>We retrospectively analysed a group of pts who underwent CMR after a clinically diagnosed acute myocarditis, between 1/2013 and 9/2017. Clinical characteristics (age, sex), inflammatory biomarkers (leukocytosis, c reactive protein), cardiac biomarkers [troponin I (TnI), creatine phosphokinase (CPK), myoglobin, brain natriuretic peptide (BNP)], electrical changes on admission (normal ST-T segment, ST segment elevation, T wave inversion, QRS duration), echocardiografic [wall motion abnormalities (WMA), left ventricle ejection fraction (LVEF)] and CMR parameters [LVEF, late gadolinium enhancement (LGE)] were analysed.</p> <p><strong>Results: </strong>A total of 60 pts were included (male gender: 45/60; 75%), with a mean age of 38.0±12.8 years. No differences were found on mean age or cardiovascular risk factors prevalence between men and women. Regarding analytical values, male gender presented higher levels of serum myoglobin (129.0±101.9 ng/mL vs 57.6±104.1, p=0.029), with no differences on other cardiac or inflammatory biomarkers. Considering electrical changes on admission, female gender is more often characterized by normal ST-T segment (26.7% vs 53.3%, p=0.05), and males had higher prevalence of ST segment elevation (51.1% vs 20.0%, p=0.035); men also presented wider QRS complexes (100±11.4 vs 86±11.4 mseg, p<0.001). No differences were found on LVEF as assessed by echocardiogram. Concerning CMR parameters, males presented lower values of LVEF (55.2±6.9 vs 61.7±7.1%, p=0.029) and higher prevalence of LGE (86 vs 60%, p=0.032), with no differences on its distribution pattern.</p> <p><strong>Conclusion: </strong>In the analysed cohort, we showed that males presented more often ST segment elevation on admission and higher QRS duration. On CMR evaluation, male gender had higher prevalence of LGE and lower LVEF. As with other cardiovascular diseases, gender seems to have impact on clinical, analytical, electrocardiographic and imaging findings of acute myocarditis.</p>
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