Our objective was to assess role of Prednisolone in Acute Myocarditis.We hypothesized that Predniosolone,administered at the 3 month of the onset of AM,will cause greater improvement and cure in comparison to the controls .
Methods
Inclusion criteria were duration of AM of 3months.173 children, age3,7±2.9years were registered ,during July2001 to Feb2007.Randomization done at the completion of 3months of disease.Patients excluded were those not showing at 3months of disease or who had ejection fraction(EF) of left ventricle >50%at randomization.68 children were randomized,44 in Prednisolone treated group (Group A)and 24 in control group(Group B).Follow up(f/u) period for 38children of groupA was 14.6±9.1months and for 19 control group children was 13.3±8.6 months.Prednisolone was given in 2mg/kg /day for 1 month with anti failure therapy(AFT) in GroupA and only AFT in GroupB .
Results:
Comparisons were made at conclusion of 1month after randomization.In group A,23 children had EF greater than 40% and 21less than 40%,while in groupB 18 had EF<40% and 6 had >40%,so groupA showed greater improvement in EF(P=0.029).Discrete analysis of change in EF of <10% and >10%or no change between groups showed significantly greater improvement in groupA(P=0.019),after 1 month of randomization.At conclusion of f/u,more children in groupA had EF of >60% compared to groupB( P=0.049). Mean EF on f/u between the groups showed higher mean EF in groupB (P=0.028).
Conclusion
Immune suppression with Prednisolone administered at 3 month of onset of AM is effective in improving EF and cure of persistent left ventricular failure in comparison to children treated with AFT alone.