Cardiac disorders worsen the final outcome in myasthenic crisis undergoing non-invasive mechanical ventilation: a retrospective 20-year study from a single center.
atrial fibrillation
hypertensive heart disease
ischaemic cardiopathy
mechanical ventilation
myasthenic crisis
Journal
Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology
ISSN: 2532-1900
Titre abrégé: Acta Myol
Pays: Italy
ID NLM: 9811169
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
14
02
2022
accepted:
07
03
2022
entrez:
25
4
2022
pubmed:
26
4
2022
medline:
27
4
2022
Statut:
epublish
Résumé
The study was performed to evaluate the impact of cardiological disorders on the outcome of myasthenic crisis (MC) requiring ventilation. The study includes 90 cases admitted to the Neurology Unit of Modena, Italy (January 2000 - September 2020). All patients were eligible for a non-invasive ventilation (NIV) trial. We analyzed the effect of cardiac comorbidities on the outcomes, which were the need of invasive ventilation, the risk tracheostomy for weaning failure and the duration of intensive care unit (ICU) stay Females were 58.9% and males 41.1%. Median age at diagnosis was 59 and at MC was 65. Patients were classified as early (EOMG) or late (LOMG), 34.4 and 65.6% respectively, according to age above or below 50; 85% of patients were anti- AChR antibody positive. Hypertension and cardiac diseases occurred at the diagnosis in 61 and 44.4%, respectively. Invasive mechanical ventilation (MV) was needed in 34% of cases. Nine subjects (10%) underwent tracheostomy because of weaning failure. Independent predictors of NIV failure were atrial fibrillation (AF), either parossistic or persistent (OR 3.05, p < 0.01), hypertensive cardiopathy (HHD) (OR 2.52, p < 0.01) and ischaemic heart disease (IHD) (OR 3.08, p < 0.01). Hypertension (HT) had no statistical effect on the outcomes. HHD was a predictor of weaning failure (OR 4.01, p = 0.017). Our study shows that HHD, AF and IHD increase the risk of NIV failure in MC receiving ventilation.
Identifiants
pubmed: 35465341
doi: 10.36185/2532-1900-064
pmc: PMC9004337
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
15-23Informations de copyright
©2022 Gaetano Conte Academy - Mediterranean Society of Myology.
Déclaration de conflit d'intérêts
Conflict of interest statement The Authors declare no conflict of interest.
Références
Eur J Neurol. 2015 Jan;22(1):17-23
pubmed: 25354676
Heart Fail Clin. 2019 Oct;15(4):531-541
pubmed: 31472888
Heart Fail Rev. 2017 Mar;22(2):191-207
pubmed: 27000754
Muscle Nerve. 2017 Dec;56(6):1041-1046
pubmed: 28214292
Acta Neurol Belg. 2020 Feb;120(1):59-64
pubmed: 30972663
J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14
pubmed: 25559473
Circ Res. 2021 Mar 19;128(6):706-719
pubmed: 33535772
Neurology. 2000 Jul 12;55(1):16-23
pubmed: 10891897
Ann Transl Med. 2018 Sep;6(18):349
pubmed: 30370276
Neurology. 2020 Jan 21;94(3):e299-e313
pubmed: 31801833
Neuromuscul Disord. 2021 Dec;31(12):1241-1250
pubmed: 34782245
Eur Heart J. 2016 Jul 14;37(27):2129-2200
pubmed: 27206819
Am J Physiol. 1967 Sep;213(3):711-8
pubmed: 6036789
Eur Heart J. 2017 Sep 21;38(36):2739-2791
pubmed: 28886619
Am J Respir Crit Care Med. 1997 May;155(5):1560-4
pubmed: 9154857
Blood Press. 2012 Dec;21(6):352-9
pubmed: 22587668
Neurocrit Care. 2005;3(3):213-5
pubmed: 16377831
Ann Indian Acad Neurol. 2019 Oct-Dec;22(4):464-471
pubmed: 31736571
Acta Myol. 2020 Dec 01;39(4):345-352
pubmed: 33458590
Ann Intensive Care. 2019 Jan 9;9(1):6
pubmed: 30627804
N Engl J Med. 2016 Dec 29;375(26):2570-2581
pubmed: 28029925
Muscle Nerve. 2019 Dec;60(6):693-699
pubmed: 31469909
J Neurol. 2016 Aug;263(8):1473-94
pubmed: 26886206
Eur J Neurol. 2014 Jul;21(7):948-55
pubmed: 24712740
J Int Med Res. 2016 Dec;44(6):1524-1533
pubmed: 27856933
Neurol India. 2020 May-Jun;68(3):648-651
pubmed: 32643679
Neurocrit Care. 2021 Oct;35(2):528-544
pubmed: 34292475
J Arrhythm. 2020 Jun 15;36(4):553-607
pubmed: 32782627
Ann Transl Med. 2018 Sep;6(18):354
pubmed: 30370281
Am J Cardiol. 1992 Jan 1;69(1):129-32
pubmed: 1729861
Neurology. 2009 May 5;72(18):1548-54
pubmed: 19414721
Curr Hypertens Rep. 2020 Feb 3;22(2):11
pubmed: 32016791
Am J Respir Crit Care Med. 1999 Aug;160(2):529-34
pubmed: 10430724
Neurology. 2011 Jun 7;76(23):2017-23
pubmed: 21562253
Eur Heart J. 2018 Sep 1;39(33):3021-3104
pubmed: 30165516
Neurol India. 2017 May-Jun;65(3):518-524
pubmed: 28488612
Respir Physiol Neurobiol. 2012 Jul 1;182(2-3):60-70
pubmed: 22609178
J Am Coll Cardiol. 2006 Feb 21;47(4):757-63
pubmed: 16487841
Neurol Sci. 2014 Jul;35(7):1109-14
pubmed: 24497206
Ann Intensive Care. 2018 Jan 9;8(1):2
pubmed: 29330683
Ann Indian Acad Neurol. 2019 Oct-Dec;22(4):472-473
pubmed: 31736572
Stat Methods Med Res. 2020 Sep;29(9):2647-2664
pubmed: 32131673
Int J Cardiol. 2005 Sep 1;103(3):335-7
pubmed: 16098399
Neurology. 1997 May;48(5):1253-60
pubmed: 9153452
J Neurol Neurosurg Psychiatry. 2006 Feb;77(2):203-7
pubmed: 16421123