{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T07:06:35Z","timestamp":1771830395377,"version":"3.50.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-114-2314-B-016-048"],"award-info":[{"award-number":["NSTC-114-2314-B-016-048"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-113-2314-B-016-024"],"award-info":[{"award-number":["NSTC-113-2314-B-016-024"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-113-2314-B-016-025-MY3"],"award-info":[{"award-number":["NSTC-113-2314-B-016-025-MY3"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-D-801GB115066"],"award-info":[{"award-number":["TSGH-D-801GB115066"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-1-C114-113-2314-B-016-024"],"award-info":[{"award-number":["TSGH-1-C114-113-2314-B-016-024"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-D-114055"],"award-info":[{"award-number":["TSGH-D-114055"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-D-113057"],"award-info":[{"award-number":["TSGH-D-113057"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-C01-113028"],"award-info":[{"award-number":["TSGH-C01-113028"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010425","name":"Tri-Service General Hospital","doi-asserted-by":"publisher","award":["TSGH-D-114054"],"award-info":[{"award-number":["TSGH-D-114054"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute fulminant myocarditis (AFM) complicated by cardiogenic shock (CS) often leads to rapid multi-organ failure. While extracorporeal life support (ECLS) is commonly used as an initial stabilizing measure, mortality remains high, particularly in patients requiring extracorporeal cardiopulmonary resuscitation (ECPR). Temporary ventricular assist devices (VADs) offer superior organ perfusion and more physiological hemodynamics compared to ECLS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective study analyzed 16 AFM patients with CS who underwent VAD implantation following ECPR between December 2015 and February 2024. Clinical data, including laboratory profiles, vasopressor use, echocardiographic findings, and neurological status, were assessed. In parallel, survival outcomes from the Taiwan National Health Insurance Research Database (NHIRD) were compared among AFM patients treated with ECMO, VAD, or no mechanical circulatory support (MCS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Of the 16 patients, 12 survived (75%) and 10 achieved cardiac recovery. Pre-VAD pulmonary artery pressure &amp;gt;40\u2005mmHg and failure to wean from epinephrine by postoperative day 1 were associated with mortality. NHIRD analysis of 1,731 myocarditis patients showed the highest 30-day survival in the VAD group (88%) compared to ECMO (52%) or no MCS (71%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AFM with CS often rapidly progresses to multi-organ failure. While ECMO provides initial circulatory support, survival remains poor once initiated. Early transition from ECMO to VAD is critical in improving survival for AFM patients with CS, particularly those receiving ECPR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1727101","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T06:30:24Z","timestamp":1771828224000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early temporary ventricular assist device intervention improves survival in fulminant myocarditis with cardiogenic shock: experience from a single centre and national cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiun-Yu","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, 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Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiang-Yu","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wu-Chien","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Tri-Service General Hospital","place":["Taipei, Taiwan"]},{"name":"School of Public Health, National Defense Medical University","place":["Taipei, Taiwan"]},{"name":"Graduate Institute of Life Sciences, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsu-Hsuan","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Tri-Service General Hospital","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Sung","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]},{"name":"Medical Affairs Bureau, Ministry of National Defense","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Chang","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Shun","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]},{"name":"Department of Combat and Disaster Medicine, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1038\/s41392-020-00360-y","article-title":"Fulminant myocarditis: a comprehensive review from etiology to treatments and outcomes","volume":"5","author":"Hang","year":"2020","journal-title":"Signal Transduct Target 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