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Acute viral myocarditis: role of immunosuppression: a prospective randomised study

  • Kalim U. Aziz (a1), Najma Patel (a1), Tareen Sadullah (a1), Habiba Tasneem (a1), Hasina Thawerani (a1) and Saeed Talpur (a1)...

Abstract

Objective

To conduct a prospective randomised study to show the efficacy of immune suppression with prednisolone, administered at the 3-month duration of acute myocarditis.

Methods

The diagnosis of acute viral myocarditis was made based on echocardiography and serum viral antibodies. The inclusion criterion was acute myocarditis of 3 months duration. In all, 68 of 173 children were available for randomisation into a prednisolone-treated group of 44 and a control group of 24 children. The follow-up period in the prednisolone-treated group was 15.1 plus or minus 9.2 months and 13.6 plus or minus 10.6 months for the control group.

Results

Compared with controls, 1 month after randomisation significantly more children in the prednisolone-treated group increased their ejection fraction to more than 40% (p = 0.029). Discrete analysis of change in the ejection fraction from the one at randomisation to one after 1 month of randomisation of greater than 10% and less than 10% or no change between groups showed a significantly greater number with improvement in the prednisolone-treated group (p = 0.019). At the end of the follow-up visits, a significantly larger number of children in the prednisolone-treated group had an ejection fraction of more than 60% compared with the control group (p = 0.049).

Conclusion

It is concluded that immune suppression with prednisolone, administered at 3 months of the onset of acute myocarditis, is effective in significantly bringing about improvement and cure in persistent left ventricular failure.

Copyright

Corresponding author

Correspondence to: K. U. Aziz, Professor Emeritus of Paediatric Cardiology, Department of Paediatric Cardiology, National Institute of Cardiovascular Diseases, Rafiqui (H.J.) Shaheed Road, Karachi, Pakistan. Tel: 92 21 586 6091; Fax: 92 21 920 1287; E-mail: heart@cyber.net.pk

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Keywords

Acute viral myocarditis: role of immunosuppression: a prospective randomised study

  • Kalim U. Aziz (a1), Najma Patel (a1), Tareen Sadullah (a1), Habiba Tasneem (a1), Hasina Thawerani (a1) and Saeed Talpur (a1)...

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