Heart failure & cardiomyopathies
Age-associated clinical patterns in paediatric myocarditis: left ventricular function as the key early risk stratifier
- prospective multicentre MYKKE registry
- external validation in the Swedish SWEDCON- cohort
+1 more
- external validation in the Swedish SWEDCON- cohort
Authors' conclusion
Reduced LVEF at presentation was the only reproducible and externally validated risk stratifier of MACE during index hospitalization. Two age-associated clinical patterns were observed: a high-risk “heart failure type” in younger children and low-risk “chest pain type” in adolescents.
Study context
- Population
- Paediatric patients with possible/definite myocarditisMYKKE registry (2013–2024), external validation cohort n = 243 · MYKKE 725 · SWEDCON 243
- Participants
- 725 patients
- Exposure
- Left ventricular ejection fraction (LVEF) as early risk stratifier for major adverse cardiovascular events (MACE) during index hospitalization
- MYKKEn = 725
- SWEDCONn = 243
Main finding
As reported in the abstract
MACE:
- MCS
- Heart transplantation
- Death during initial admission
| Group | Value | Mechanical circulatory support (MCS) | Transplantation | Death |
|---|---|---|---|---|
| MYKKE | 12.2% | 10.9% | 4.3% | 2.2% |
| SWEDCON | 7.4% |
Observational data: associations, not effects.
Further findings
| Outcome | OR (per 1% increase) (95% CI) | P value | |
|---|---|---|---|
| LVEF and MACE | 0.90 (0.881–0.917) | P < 0.01 | |
| 0.512Odds ratio (log scale) |
- LVEF and MACE — AUC
- 0.90, 95% CI 0.896-0.903
Risk stratifier selection (MOB)
- LVEF ≤ 39% as the only stable risk stratifier
- ≤ 39%
- “heart failure type” in younger children
- 1.9 years; LVEF 24%
- “chest pain type” in adolescents with preserved LVEF
- 15.6 years; LVEF 59%
External validation discrimination (SWEDCON)
- AUC
- 0.894, 95% CI 0.80-0.991
Original publication
Age-associated clinical patterns in paediatric myocarditis: left ventricular function as the key early risk stratifier. ESC Heart Fail. Published 15 October 2026. doi:10.
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Summarised from the published abstract; every number is checked against it