Background/aim: Myocarditis in the acute phase usually presents with sinus tachycardia but many other arrhythmias might be seen as well. In this study we aimed to investigate repolarization abnormalities in baseline ECG of patients with myocarditis for the first time.Materials and methods: Thirty patients diagnosed with myocarditis and 25 healthy age-matched controls were included. Two different cardiologists measured corrected QT (QTc), QT dispersion (QTd), QT peak (QTp), T wave peak to T wave end (TpTe), TpTe/QT ratio, and TpTe/QTc ratio in 12-lead ECG.Results: When compared with the control group, QTp (P: 0.021), QT (P: 0.003), TpTe (P < 0.001), TpTe/QTc ratio (P < 0.001), and TpTe/QT ratio (P: 0.005) were significantly higher in patients with myocarditis. A comparison of receiver operating characteristic (ROC) curves was conducted using the Hanley and McNeil method. The area under the curve (AUC) of the electrocardiographic characteristics QT (AUC: 0.736; 95% CI [0.600-0.846]), QTP (AUC: 0.680; 95% CI [0.540-0.799]), and TpTe (AUC: 0.771; 95% CI [0.638-873]) and TpTe/QTc (AUC: 0.774; 95% CI [0.641-0.876]) and TpTe/QT (AUC: 0.726; 95% CI [0.589-0.838]) in myocarditis were not significantly different from each other but all of them were different from 0.5.Conclusion: Baseline ECGs of patients with myocarditis were associated with repolarization abnormalities. These novel findings may be one of the reasons underlying arrhythmic events in patients with myocarditis.
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http://dx.doi.org/10.3906/sag-1612-39 | DOI Listing |
Infect Dis Rep
November 2024
Department of Internal Medicine and Infectious Diseases, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
Invasive aspergillosis (IA) is an opportunistic fungal infection that typically occurs in the immunocompromised host and is associated with severe morbidity and mortality. Myocardial abscess formation is seldomly described. We present a case of IA with purulent myocarditis.
View Article and Find Full Text PDFGeriatrics (Basel)
December 2024
Klinik für Herzchirurgie, Klinikum Nürnberg-Paracelsus Medical University, 90471 Nuremberg, Germany.
We report the case of a 78-year-old female patient who received palliative immunotherapy with pembrolizumab and lenvatinib as a treatment of pulmonary and osseous metastatic endometrial carcinoma. Under this therapy, the patient developed dysphagia, thyroiditis with hypothyroidism, myositis, and myocarditis, which required, due to third-degree AV block, the installation of a pacemaker. The patient received high-dose cortisone therapy, a thyroid hormone substitution, and pyridostigmine for symptom control.
View Article and Find Full Text PDFAm J Case Rep
December 2024
Division of Infectious Diseases, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
BACKGROUND Human metapneumovirus (hMPV), classified in the Pneumoviridae family, is primarily known for causing lower respiratory tract infections in children, the elderly, and immunocompromised individuals. However, rare instances have shown that hMPV can also affect other systems, such as the cardiovascular system, leading to conditions like myocarditis. CASE REPORT We describe a 68-year-old man with a medical history of diabetes, hypertension, and liver cirrhosis who presented to the Emergency Department (ED) exhibiting symptoms of fever, cough, and dyspnea.
View Article and Find Full Text PDFMed Int (Lond)
December 2024
Department of Neurology, University of Alabama, Birmingham, AL 35294, USA.
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by enhancing the ability of the immune system to combat malignancies. Nivolumab and cemiplimab, monoclonal antibodies targeting programmed cell death protein 1, have exhibited notable therapeutic efficacy; however, they are associated with immune-related adverse events (irAEs). The present study describes the cases of 2 patients, a 71-year-old male with metastatic esophageal adenocarcinoma and a 66-year-old female with metastatic squamous cell carcinoma who developed acute/subacute onset rapidly progressive myositis/myasthenia gravis (MG) following treatment with nivolumab and cemiplimab.
View Article and Find Full Text PDFJ Am Heart Assoc
December 2024
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA.
Background: Immune checkpoint inhibitors have improved the clinical outcomes of several cancers but have also been associated with a greater risk of immune-related adverse effects, especially when combined. The objective of this study was to investigate the incidence of myocarditis in relation to the use of dual concurrent versus single immune checkpoint inhibitors therapies.
Methods And Results: A cohort study was conducted using medical and pharmacy claims data (2011-2022) from a large US commercial insurer.
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