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Heart failure & cardiomyopathiesCohort study

Prognostic impact of pericardial effusion in patients with acute myocarditis

Eur Heart J Acute Cardiovasc CarePublished

  • observational ambispective cohort study
  • based on the AMPHIBIA registry (Assistance Publique-Hôpitaux de Paris/ACTION Study Group)
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Authors' conclusion

This study characterizes the phenotypes and outcomes of patients hospitalized for an AM, with and without pericardial effusion. Pericardial involvement was associated with LV dysfunction, immunological myocarditis, elevated CRP, and fever and was linked to a markedly higher risk of the composite outcome, remaining an independent predictor of adverse events. Differentiating these two phenotypes may provide physicians with valuable guidance for managing therapy in these patients.

Study context

Population
Patients hospitalized for proven acute myocarditis (AM) between August 2008 and December 2024 at La Pitié Salpêtrière Hospital, Paris, Francepatients with AM, follow-up 3.7 (1.3–7.3) years · with pericardial effusion 134 · without pericardial effusion 447
Participants
581 patients
Exposure
Patients with vs without pericardial effusion
  • pericardial effusionn = 134
  • without pericardial effusionn = 447reference
Outcome
Main composite outcome:
  • All-cause death
  • Temporary mechanical circulatory support
  • Severe ventricular arrhythmia
  • Heart transplantation
Follow-up
At the longest , up to 7 years

Main finding

As reported in the abstract

pericardial effusion vs without pericardial effusionHRP value
Main composite outcome: all-cause death, temporary mechanical circulatory support, severe ventricular arrhythmia, and heart transplantation
2.69(95% CI 1.88–3.86)
P < 0.001
multivariable analysis
1.99(CI 1.32–3.00)
P < 0.001

Observational data: associations, not effects.

Further findings

Independent variables associated with pericardial effusion at admission

left ventricular (LV) dysfunction, immunological myocarditis, elevated CRP, and fever

Original publication

Prognostic impact of pericardial effusion in patients with acute myocarditis. Eur Heart J Acute Cardiovasc Care. Published 31 August 2026. doi:10.1093/ehjacc/zuag090
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Summarised from the published abstract; every number is checked against it