Myocarditis plus pulmonary hypertension means transplant sooner

DALLAS, March 19 Pulmonary hypertension can predict death for people with myocarditis and suggests the need for a heart transplant or other aggressive therapy sooner, according to a report in todays rapid access Circulation: Journal of the American Heart Association.

Pulmonary hypertension is a lung disorder in which the blood pressure rises in the pulmonary artery, the blood vessel that carries blood from the heart to the lungs. Myocarditis is inflammation of the heart muscle caused by conditions including infection, rheumatic fever, diphtheria, tuberculosis or toxic drug poisoning. For each 5mmHg increase in pulmonary pressure, researchers found that the death rate increased 85 percent in individuals with myocarditis. For those without myocarditis, who had other forms of heart failure, mortality rates increased by 23 percent.

This paper is unique in finding an association between pulmonary pressure and myocarditis. This suggests that not only are the hemodynamics (blood circulation factors) of the disease important, but the form of cardiomyopathy is important as well, says Edward K. Kasper, M.D., one of the studys authors. This information can help doctors decide who has the greatest need for a heart transplant, or which patients need more aggressive therapy.

According to Kasper, who is director of the Johns Hopkins Cardiomyopathy and Heart Transplant Service, this study is the largest systematic analysis of hemodynamic data in patients with cardiomyopathy and congestive heart failure. Researchers studied 1,134 patients (455 women and 679 men), average age 48 years, with new cardiomyopathy, which is a general term for serious primary noninflammatory disease of the heart muscle. Participants were followed for an average of 4.4 years.

At the beginning of the study, participants underwent right heart catheterization. Researchers then measured average pulmonary arterial pressure among other parameters. During the follow-up period,

Contact: Carole Bullock
American Heart Association

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