ArticleInternational journal of general medicine2025
Angiotensin-Converting Enzyme Inhibitors Mitigate Development of Chronic Persistent Cardiac Dysfunction Following Fulminant Myocarditis: A Multicenter Retrospective Study in China.
Article in International journal of general medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Post-viral myocarditis.Heart failure reviews · 2026Review
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although temporary mechanical circulatory supports (tMCS) combined with immunoregulatory therapy (IT) can reduce the mortality of patients with fulminant myocarditis (FM), a considerable proportion still progress to chronic persistent cardiac dysfunction. It is unclear if angiotensin-converting enzyme (ACE) inhibitors can further prevent such dysfunction under tMCS combined with IT. Methods: This multicenter, retrospective, observational study included 124 FM patients with a left ventricular ejection fraction (LVEF) ≤ 40%. Among them, 90 (72.58%) received ACE inhibitors and 34 (27.42%) did not. Patients had echocardiography during follow-up. Logistic regression analysis, subgroup analysis, and restricted cubic spline modeling were used to identify clinical variables associated with the primary outcome. Results: The primary outcome was defined as an LVEF < 55% at the last follow-up. The median follow-up was 12 (6, 18) months. 46 patients (37.1%) had an LVEF < 55% at the last follow-up. Among them, 25 (27.78%) received ACE inhibitors and 21 (61.76%) did not. In the non-ACE inhibitors group, LVEF declined from baseline over 24 months. Among the 49 patients (39.52%) with a left ventricular end-diastolic dimension (LVEDD) ≥ 5cm at admission, 29 (59.18%) had an LVEF < 55% at the last follow-up. 15 patients (51.72%) took ACE inhibitors and 14 (48.28%) did not. Multivariate logistic regression analysis revealed that ACE inhibitors (HR = 0.19, 95% CI: 0.04-0.96, P = 0.045) and LVEDD (HR = 9.18, 95% CI: 2.73-30.83, P < 0.001) were independently associated with an LVEF < 55% at the last follow-up, and the risk increased linearly with LVEDD (P for nonlinear > 0.05). Conclusion: ACE inhibitors may improve left ventricular (LV) function and prevent chronic persistent cardiac dysfunction in FM patients. Although they can partially reverse LV remodeling, increased LVEDD during long-term follow-up may reduce their therapeutic benefits.
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