Clinical study of extracorporeal membrane oxygenation and left ventricular function in patients with acute fulminant myocarditis / 中华急诊医学杂志

ABSTRACT

Objective:To evaluate left ventricular systolic function (LVEF) after extracorporeal membrane oxygenation (ECMO) in patients with acute fulminant myocarditis (AFM).Methods:Seven patients were admitted in the First Affiliated Hospital of Nanjing Medical University from August 2018 to November 2018. All the patients accepted veno-arterial extracorporeal membrane oxygenation (V-AECMO). Complications associated with ECMO and clinical outcome were documented. Transthoracic echocardiography (TTE), single photo emission computed tomography (SPECT), and cardiac magnetic resonance (CMR)were performed to evaluate LVEF.Results:Seven patients were successfully weaned from V-AECMO, 2 of whom had oxygenator leakage, 4 had femoral artery bleeding after decannulation, and 2 had femoral artery pesudoaneurysm. There was no statistical difference in LVEF evaluation between TTE and CMR [(62.4±6.8)% vs (58.9±8.2)%, P >0.05]. CMR and SPECT further revealed myocardial pathological change and coronary arterial blood perfusion. Conclusions:ECMO is recommended in patients with AFM. TTE is simple and easy to perform and is not inferior to CMR in LVEF evaluation. CMR can reflect pathological changes of cardiomyocytes at the cellular level, and SPECT can reflect coronary perfusion.