Long-Term Outcomes in Survivors of Fulminant Myocarditis Supported with Venoarterial Extracorporeal Membrane Oxygenation by Discharge Cardiac Function
Abstract
Background: Fulminant myocarditis (FM) is a life-threatening cause of cardiogenic shock. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is often employed as a bridge to recovery, but data on long-term outcomes and prognostic markers post-discharge remain limited. We described long-term outcomes and explored the association between discharge left ventricular ejection fraction (LVEF) and post-discharge events. Methods: This retrospective, international, multicentre cohort study included adult FM patients who required VA-ECMO and survived to hospital discharge. Patients were stratified by LVEF ≥ 50% or < 50% at discharge. Cox proportional hazards models were used to assess the association between discharge LVEF and the primary composite endpoint of death, heart transplantation, or durable mechanical circulatory support postdischarge. Results: A total of 106 patients from 11 centres were included, with a median age of 43 years (interquartile range 29-57); 42% were male. At discharge, LVEF was ≥ 50% in 69 patients and < 50% in 37 patients. Over a median follow-up of 4.4 years (interquartile range 1.6-7.9), 3 patients (2.8%) experienced the composite outcome (2 deaths, 1 left ventricular assist device implantation). Compared with patients discharged with an LVEF ≥ 50%, those with an LVEF < 50% had a numerically higher risk of the composite endpoint (hazard ratio 2.9, 95% confidence interval 0.19-42.9), although this difference was not statistically significant. Conclusions: Given the low number of postdischarge events, this study was underpowered to assess the prognostic value of discharge LVEF. However, long-term outcomes were favourable among survivors of FM supported with VA-ECMO, regardless of their LVEF at discharge.
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BibTeX
@article{lambadaris2026longterm,
title = {{Long-Term Outcomes in Survivors of Fulminant Myocarditis Supported with Venoarterial Extracorporeal Membrane Oxygenation by Discharge Cardiac Function}},
author = {Maria Lambadaris and Julie Vishram-Nielsen and Takahiro Okumura and Yee-Chun Chen and Aristine Cheng and Hsin-Yun Sun and Antonio Loforte and Yasuhide Asaumi and Kenichiro Sawada and Mingjie Huang and Wei Lee and Thomas Fux and Matteo Pozzi and Heather Ross and Finn Gustafsson and Hasse Møller-Sørensen and Albert Ariza-Solé and Mario Senechal and Pierre Yves Turgeon and Manuel Martinez-Selles and Francisco Hernández-Pérez and Roberto Lorusso and Filio Billia and Ana Alba and Julie K.K. Vishram-Nielsen},
journal = {Canadian Journal of Cardiology (CJC) : official journal of the Canadian Cardiovascular Society (CCS)},
year = {2026},
month = sep,
doi = {10.1016/j.cjco.2026.03.020},
url = {https://hal.science/hal-05749372v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-Term Outcomes in Survivors of Fulminant Myocarditis Supported with Venoarterial Extracorporeal Membrane Oxygenation by Discharge Cardiac Function
AU - Maria Lambadaris
AU - Julie Vishram-Nielsen
AU - Takahiro Okumura
AU - Yee-Chun Chen
AU - Aristine Cheng
AU - Hsin-Yun Sun
AU - Antonio Loforte
AU - Yasuhide Asaumi
AU - Kenichiro Sawada
AU - Mingjie Huang
AU - Wei Lee
AU - Thomas Fux
AU - Matteo Pozzi
AU - Heather Ross
AU - Finn Gustafsson
AU - Hasse Møller-Sørensen
AU - Albert Ariza-Solé
AU - Mario Senechal
AU - Pierre Yves Turgeon
AU - Manuel Martinez-Selles
AU - Francisco Hernández-Pérez
AU - Roberto Lorusso
AU - Filio Billia
AU - Ana Alba
AU - Julie K.K. Vishram-Nielsen
PY - 2026
DA - 2026/09/14
JO - Canadian Journal of Cardiology (CJC) : official journal of the Canadian Cardiovascular Society (CCS)
DO - 10.1016/j.cjco.2026.03.020
UR - https://hal.science/hal-05749372v1
AB - Background: Fulminant myocarditis (FM) is a life-threatening cause of cardiogenic shock. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is often employed as a bridge to recovery, but data on long-term outcomes and prognostic markers post-discharge remain limited. We described long-term outcomes and explored the association between discharge left ventricular ejection fraction (LVEF) and post-discharge events. Methods: This retrospective, international, multicentre cohort study included adult FM patients who required VA-ECMO and survived to hospital discharge. Patients were stratified by LVEF ≥ 50% or < 50% at discharge. Cox proportional hazards models were used to assess the association between discharge LVEF and the primary composite endpoint of death, heart transplantation, or durable mechanical circulatory support postdischarge. Results: A total of 106 patients from 11 centres were included, with a median age of 43 years (interquartile range 29-57); 42% were male. At discharge, LVEF was ≥ 50% in 69 patients and < 50% in 37 patients. Over a median follow-up of 4.4 years (interquartile range 1.6-7.9), 3 patients (2.8%) experienced the composite outcome (2 deaths, 1 left ventricular assist device implantation). Compared with patients discharged with an LVEF ≥ 50%, those with an LVEF < 50% had a numerically higher risk of the composite endpoint (hazard ratio 2.9, 95% confidence interval 0.19-42.9), although this difference was not statistically significant. Conclusions: Given the low number of postdischarge events, this study was underpowered to assess the prognostic value of discharge LVEF. However, long-term outcomes were favourable among survivors of FM supported with VA-ECMO, regardless of their LVEF at discharge.
SN - 2589-790X
ER -