Thorac Cardiovasc Surg 2018; 66(S 02): S111-S138
DOI: 10.1055/s-0038-1628324
Oral Presentations
Monday, February 19, 2018
DGPK: Basic Science and Clinical Studies
Georg Thieme Verlag KG Stuttgart · New York

Four-Year Experience of the German Multicenter Registry for Pediatric Patients with Suspected Myocarditis: MYKKE

F. Degener
1   Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
,
B. Opgen-Rhein
3   Charité - Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Kardiologie, Berlin, Germany
,
M. Böhne
4   Medizinische Hochschule Hannover, Kinderkardiologie, Hannover, Germany
,
A. Weigelt
5   Universitätsklinikum Erlangen, Kinderkardiologie, Erlangen, Germany
,
R. Wagner
6   Herzzentrum Leipzig, Kinderkardiologie, Leipzig, Germany
,
G. Müller
7   Universitäres Herzzentrum Hamburg, Kinderkardiologie, Hamburg, Germany
,
A. Racolta
8   Herz- und Diabeteszentrum NRW, Zentrum für angeborene Herzfehler, Bad Oeynhausen, Germany
,
A. Rentzsch
9   Universität des Saarlandes, Kinderkardiologie, Homburg/Saar, Germany
,
K. Papakostas
10   Klinikum Links der Weser, Strukturelle und angeborene Herzfehler / Kinderkardiologie, Bremen, Germany
,
K. Reineker
11   Universitäts Herzzentrum Freiburg Bad Krozingen, Kinderkardiologie, Freiburg, Germany
,
D. Kiski
12   Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin/Pädiatrische Kardiologie, Münster, Germany
,
B. Ruf
13   Deutsches Herzzentrum München, Technische Universität München, Angeborene Herzfehler/Kinderkardiologie, München, Germany
,
G. Wiegand
14   Universitätskinderklinik Tübingen, Kinderkardiologie, Tübingen, Germany
,
T. Hannes
15   Uniklinik Köln, Klinik für angeborene Herzfehler und Pädiatrische Kardiologie, Köln, Germany
,
M. Khalil
16   Universitätsklinik Giessen, Abteilung für Kinderkardiologie, Giessen, Germany
,
M. Fischer
17   Klinikum der Universität München, Abteilung Kinderkardiologie und Pädiatrische Intensivmedizin, München, Germany
,
M. Kaestner
18   Universitätsklinikum Ulm, Kinderkardiologie, Ulm, Germany
,
M. Steinmetz
19   Universitätsmedizin Göttingen, Klinik für Pädiatrische Kardiologie und Intensivmedizin, Göttingen, Germany
,
G. Fischer
20   Universitätsklinikum Schleswig-Holstein, Klinik für angeborene Herzfehler und Kinderkardiologie, Kiel, Germany
,
N. Freudenthal
21   Universitätsklinikum Bonn, Abteilung für Kinderkardiologie, Bonn, Germany
,
T. Pickardt
22   Kompetenznetz Angeborene Herzfehler, Berlin, Germany
,
D. Messroghli
2   DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Standort Berlin, Berlin, Germany
,
S. Schubert
1   Deutsches Herzzentrum Berlin, Klinik für Angeborene Herzfehler - Kinderkardiologie, Berlin, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

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Objectives: Myocarditis is one of the leading causes of severe heart failure in children. In pediatric myocarditis, the development of severe heart failure may depend on age, genetic and immunological factors. MYKKE aims to close this knowledge gap by acquiring data on incidence, diagnostic and therapeutic approaches.

Methods: MYKKE is a multicenter prospective data acquisition on hospitalized pediatric patients with suspected myocarditis. Between September 2013 and 2017 twenty centers included clinical data into an online database.

Results: A total of 272 patients were included, 67% male, median age (range) 13 (0–17) years with two age peaks: 0 to < 2 years (24%), 2 to 12 years (21%), and 13 to 18 years (55%). Leading symptoms at admission were: decrease of exercise capacity (68%), angina (39%), dyspnea (36%), arrhythmia (28%), and syncope (18%). Sudden cardiac death occurred rarely (4%). 55% had general symptom`s caused by infection within the last 6 weeks, fever in 35%. Patients under 2 years of age had a higher incidence of a severely reduced left ventricular ejection fraction (EF< 30%) compared with age groups 2 to 12 years (40%) and 13–18y (7%); p < 0.001. They also had the highest need for ventricular assist device (VAD) and/or ECMO therapy (23%; 2–12 years 18%; 13–18 years 4%); p < 0.001.

Fifteen patients died during follow-up, 8 of them have had a VAD/ECMO therapy, which means an overall mortality of 5.5% and 21% in the ECMO/VAD group (n = 8/31). Most children died in the 0- to < 2-year (11%) and 2- to 12-year group (11%) compared with 1% in the 13–18-year group. Eighteen patients were directed to heart transplantation (HTx) and in eleven patients HTx was performed.

Conclusion: With its ongoing enrollment, MYKKE has become a valuable registry for suspected myocarditis in children and adolescents. The data underline two age peaks and age depending outcomes, with a more severe clinical course including VAD/ECMO therapy and more adverse events in the youngest patients. These differences within the age groups will be further studied in the registry by genetic and immunological analyzes.