Heart failure & cardiomyopathies
Clinical Impact of Follow-Up Endomyocardial Biopsy in Myocarditis During or After Immune-Suppressive Therapy
Authors' conclusion
One-fourth of EMB-proven myocarditis patients had a clinical indication to repeat EMB at least once during long-term follow-up. Follow-up EMB was safe in all cases; it showed active or borderline myocarditis in 55% of patients and lead to a change in management in the majority of patients.
Study context
- Population
- Patients with virus-negative endomyocardial biopsy (EMB)-proven myocarditis treated with IMT22 received at least one follow-up EMB
- Participants
- 92 patients
- Exposure
- Patients receiving follow-up EMB vs those not receiving it
- Follow-up EMBn = 22
- Outcome
- Indication for follow-up EMB
Main finding
As reported in the abstract
Clinical worsening
n = 12
Suspected myocarditis relapse
n = 7
To assess IMT response
n = 3
Observational data: associations, not effects.
Further findings
Characteristics of patients receiving follow-up EMB · at diagnosis
- More likely abnormal troponin levels
- P = 0.048
- Trend towards lower prevalence of anti-heart auto-antibodies positivity
- P = 0.05
- Worse imaging findings at follow-up
Findings on follow-up EMB and management change
- Active or borderline myocarditis on follow-up EMB
- 12 patients
- Change in IMT regimen among those with active or borderline myocarditis
- 10 (83%)
- Among patients with healed myocarditis: change in IMT regimen
- 2
- Among patients with healed myocarditis: heart transplant evaluation check list
- 2
- Among patients with healed myocarditis: mitral valve treatment
- 2
- Among patients with healed myocarditis: ventricular tachycardia ablation
- 1
- Among patients with healed myocarditis: primary prevention implantable cardioverter-defibrillator implantation
- 1
Original publication
Clinical Impact of Follow-Up Endomyocardial Biopsy in Myocarditis During or After Immune-Suppressive Therapy. ESC Heart Fail. Published 30 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it