Complete recovery of fulminant cytotoxic CD8 T-cell-mediated myocarditis after ECMELLA unloading and immunosuppression

Ivana Jurcova; Jan Rocek; William Bracamonte-Baran; Michael Zelizko; Ivan Netuka; Jana Maluskova; Josef Kautzner; Daniela Cihakova; Vojtech Melenovsky; Jiri Maly

doi:10.1002/ehf2.12697

Complete recovery of fulminant cytotoxic CD8 T-cell-mediated myocarditis after ECMELLA unloading and immunosuppression

Ivana Jurcova, Jan Rocek, William Bracamonte-Baran, Michael Zelizko, Ivan Netuka, Jana Maluskova, Josef Kautzner, Daniela Cihakova, Vojtech Melenovsky, Jiri Maly

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

A 19-year-old woman with no previous cardiac history was admitted to the hospital with third-degree atrioventricular block and left ventricular dysfunction. Her condition quickly deteriorated to severe biventricular failure and cardiogenic shock requiring mechanical circulatory support. An endomyocardial biopsy revealed lymphocytic myocarditis with no PCR-detectable viral genomes, with CD8 T-cell predominance and pro-inflammatory macrophage expansion shown by myocardial flow cytometry. The therapy consisted of immunosuppression (high-dose methylprednisolone) and temporary mechanical circulatory support with enhanced ability to achieve left ventricular unloading by combination of extracorporeal membrane oxygenation with Impella (ECMELLA). After 2 weeks of support, complete and sustained recovery from myocarditis was observed.

Original language	English (US)
Pages (from-to)	1976-1981
Number of pages	6
Journal	ESC Heart Failure
Volume	7
Issue number	4
DOIs	https://doi.org/10.1002/ehf2.12697
State	Published - Aug 1 2020

Keywords

Extracorporeal membrane oxygenation (ECMO)
Fulminant myocarditis
Immunosuppression
Mechanical circulatory support

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1002/ehf2.12697

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Complete recovery of fulminant cytotoxic CD8 T-cell-mediated myocarditis after ECMELLA unloading and immunosuppression. / Jurcova, Ivana; Rocek, Jan; Bracamonte-Baran, William; Zelizko, Michael; Netuka, Ivan; Maluskova, Jana; Kautzner, Josef; Cihakova, Daniela; Melenovsky, Vojtech; Maly, Jiri.

In: ESC Heart Failure, Vol. 7, No. 4, 01.08.2020, p. 1976-1981.

Research output: Contribution to journal › Article › peer-review

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abstract = "A 19-year-old woman with no previous cardiac history was admitted to the hospital with third-degree atrioventricular block and left ventricular dysfunction. Her condition quickly deteriorated to severe biventricular failure and cardiogenic shock requiring mechanical circulatory support. An endomyocardial biopsy revealed lymphocytic myocarditis with no PCR-detectable viral genomes, with CD8 T-cell predominance and pro-inflammatory macrophage expansion shown by myocardial flow cytometry. The therapy consisted of immunosuppression (high-dose methylprednisolone) and temporary mechanical circulatory support with enhanced ability to achieve left ventricular unloading by combination of extracorporeal membrane oxygenation with Impella (ECMELLA). After 2 weeks of support, complete and sustained recovery from myocarditis was observed.",

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author = "Ivana Jurcova and Jan Rocek and William Bracamonte-Baran and Michael Zelizko and Ivan Netuka and Jana Maluskova and Josef Kautzner and Daniela Cihakova and Vojtech Melenovsky and Jiri Maly",

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AU - Jurcova, Ivana

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AU - Bracamonte-Baran, William

AU - Zelizko, Michael

AU - Netuka, Ivan

AU - Maluskova, Jana

AU - Kautzner, Josef

AU - Cihakova, Daniela

AU - Melenovsky, Vojtech

AU - Maly, Jiri

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N2 - A 19-year-old woman with no previous cardiac history was admitted to the hospital with third-degree atrioventricular block and left ventricular dysfunction. Her condition quickly deteriorated to severe biventricular failure and cardiogenic shock requiring mechanical circulatory support. An endomyocardial biopsy revealed lymphocytic myocarditis with no PCR-detectable viral genomes, with CD8 T-cell predominance and pro-inflammatory macrophage expansion shown by myocardial flow cytometry. The therapy consisted of immunosuppression (high-dose methylprednisolone) and temporary mechanical circulatory support with enhanced ability to achieve left ventricular unloading by combination of extracorporeal membrane oxygenation with Impella (ECMELLA). After 2 weeks of support, complete and sustained recovery from myocarditis was observed.

AB - A 19-year-old woman with no previous cardiac history was admitted to the hospital with third-degree atrioventricular block and left ventricular dysfunction. Her condition quickly deteriorated to severe biventricular failure and cardiogenic shock requiring mechanical circulatory support. An endomyocardial biopsy revealed lymphocytic myocarditis with no PCR-detectable viral genomes, with CD8 T-cell predominance and pro-inflammatory macrophage expansion shown by myocardial flow cytometry. The therapy consisted of immunosuppression (high-dose methylprednisolone) and temporary mechanical circulatory support with enhanced ability to achieve left ventricular unloading by combination of extracorporeal membrane oxygenation with Impella (ECMELLA). After 2 weeks of support, complete and sustained recovery from myocarditis was observed.

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