Early prediction model for successful bridge to recovery in patients with fulminant myocarditis supported with percutaneous venoarterial extracorporeal membrane oxygenation ― Insights from the change pump study ―

The CHANGE PUMP Investigators

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3 Citations (Scopus)

Abstract

Background: Cardiac recovery and prevention of end-organ damage are the cornerstones of establishing successful bridge to recovery (BTR) in patients with fulminant myocarditis (FM) supported with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, the timing and method of successful BTR prediction still remain unclear. We aimed to develop a prediction model for successful BTR in patients with FM supported with percutaneous VA-ECMO. Methods and Results: This was a retrospective multicenter chart review enrolling 99 patients (52±16 years; female, 42%) with FM treated with percutaneous VA-ECMO. The S-group comprised patients who experienced percutaneous VA-ECMO decannulation and subsequent discharge (n=46), and the F-group comprised patients who either died in hospital or required conversion to other forms of mechanical circulatory support (n=53). At VA-ECMO initiation (0-h), the S-group had significantly higher left ventricular ejection fraction (LVEF) and lower aspartate aminotransferase (AST) concentration than the F-group. At 48 h, the LVEF, increase in the LVEF, and reduction of AST from 0-h were identified as independent predictors in the S-group. Finally, we developed an S-group prediction model comprising these 3 variables (area under the curve, 0.844; 95% confidence interval, 0.745–0.944). Conclusions: We developed a model for use 48 h after VA-ECMO initiation to predict successful BTR in patients with FM.

Original languageEnglish
Pages (from-to)699-707
Number of pages9
JournalCirculation Journal
Volume82
Issue number3
DOIs
Publication statusPublished - 01-01-2018

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Extracorporeal Membrane Oxygenation
Myocarditis
Stroke Volume
Aspartate Aminotransferases
Area Under Curve
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Early prediction model for successful bridge to recovery in patients with fulminant myocarditis supported with percutaneous venoarterial extracorporeal membrane oxygenation ― Insights from the change pump study ―",
abstract = "Background: Cardiac recovery and prevention of end-organ damage are the cornerstones of establishing successful bridge to recovery (BTR) in patients with fulminant myocarditis (FM) supported with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, the timing and method of successful BTR prediction still remain unclear. We aimed to develop a prediction model for successful BTR in patients with FM supported with percutaneous VA-ECMO. Methods and Results: This was a retrospective multicenter chart review enrolling 99 patients (52±16 years; female, 42{\%}) with FM treated with percutaneous VA-ECMO. The S-group comprised patients who experienced percutaneous VA-ECMO decannulation and subsequent discharge (n=46), and the F-group comprised patients who either died in hospital or required conversion to other forms of mechanical circulatory support (n=53). At VA-ECMO initiation (0-h), the S-group had significantly higher left ventricular ejection fraction (LVEF) and lower aspartate aminotransferase (AST) concentration than the F-group. At 48 h, the LVEF, increase in the LVEF, and reduction of AST from 0-h were identified as independent predictors in the S-group. Finally, we developed an S-group prediction model comprising these 3 variables (area under the curve, 0.844; 95{\%} confidence interval, 0.745–0.944). Conclusions: We developed a model for use 48 h after VA-ECMO initiation to predict successful BTR in patients with FM.",
author = "{The CHANGE PUMP Investigators} and Akinori Sawamura and Takahiro Okumura and Akihiro Hirakawa and Masaaki Ito and Yukio Ozaki and Nobuyuki Ohte and Tetsuya Amano and Toyoaki Murohara",
year = "2018",
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day = "1",
doi = "10.1253/circj.CJ-17-0549",
language = "English",
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pages = "699--707",
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T1 - Early prediction model for successful bridge to recovery in patients with fulminant myocarditis supported with percutaneous venoarterial extracorporeal membrane oxygenation ― Insights from the change pump study ―

AU - The CHANGE PUMP Investigators

AU - Sawamura, Akinori

AU - Okumura, Takahiro

AU - Hirakawa, Akihiro

AU - Ito, Masaaki

AU - Ozaki, Yukio

AU - Ohte, Nobuyuki

AU - Amano, Tetsuya

AU - Murohara, Toyoaki

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Cardiac recovery and prevention of end-organ damage are the cornerstones of establishing successful bridge to recovery (BTR) in patients with fulminant myocarditis (FM) supported with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, the timing and method of successful BTR prediction still remain unclear. We aimed to develop a prediction model for successful BTR in patients with FM supported with percutaneous VA-ECMO. Methods and Results: This was a retrospective multicenter chart review enrolling 99 patients (52±16 years; female, 42%) with FM treated with percutaneous VA-ECMO. The S-group comprised patients who experienced percutaneous VA-ECMO decannulation and subsequent discharge (n=46), and the F-group comprised patients who either died in hospital or required conversion to other forms of mechanical circulatory support (n=53). At VA-ECMO initiation (0-h), the S-group had significantly higher left ventricular ejection fraction (LVEF) and lower aspartate aminotransferase (AST) concentration than the F-group. At 48 h, the LVEF, increase in the LVEF, and reduction of AST from 0-h were identified as independent predictors in the S-group. Finally, we developed an S-group prediction model comprising these 3 variables (area under the curve, 0.844; 95% confidence interval, 0.745–0.944). Conclusions: We developed a model for use 48 h after VA-ECMO initiation to predict successful BTR in patients with FM.

AB - Background: Cardiac recovery and prevention of end-organ damage are the cornerstones of establishing successful bridge to recovery (BTR) in patients with fulminant myocarditis (FM) supported with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, the timing and method of successful BTR prediction still remain unclear. We aimed to develop a prediction model for successful BTR in patients with FM supported with percutaneous VA-ECMO. Methods and Results: This was a retrospective multicenter chart review enrolling 99 patients (52±16 years; female, 42%) with FM treated with percutaneous VA-ECMO. The S-group comprised patients who experienced percutaneous VA-ECMO decannulation and subsequent discharge (n=46), and the F-group comprised patients who either died in hospital or required conversion to other forms of mechanical circulatory support (n=53). At VA-ECMO initiation (0-h), the S-group had significantly higher left ventricular ejection fraction (LVEF) and lower aspartate aminotransferase (AST) concentration than the F-group. At 48 h, the LVEF, increase in the LVEF, and reduction of AST from 0-h were identified as independent predictors in the S-group. Finally, we developed an S-group prediction model comprising these 3 variables (area under the curve, 0.844; 95% confidence interval, 0.745–0.944). Conclusions: We developed a model for use 48 h after VA-ECMO initiation to predict successful BTR in patients with FM.

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U2 - 10.1253/circj.CJ-17-0549

DO - 10.1253/circj.CJ-17-0549

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VL - 82

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EP - 707

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 3

ER -