Heart failure & cardiomyopathiesDiagnostic or prognostic study
Endomyocardial Biopsy-Based Inflammatory Phenotypes Predict Outcomes in Virus-Negative Dilated and Inflammatory Cardiomyopathy
- Prognostic cohort study
Authors' conclusion
Quantitative inflammatory phenotyping of EMB provides independent prognostic information in virus-negative CMi.
Study context
- Population
- Virus-negative patients with unexplained HF undergoing EMB, no immunosuppressive therapyof 1,467 undergoing EMB
- Participants
- 478 patients
- Comparison
- Inflammatory phenotypes on EMB vs no inflammation
- Outcome
- Mortality, deterioration in LVEF and persistent systolic dysfunction
- Follow-up
- Median 26 months (Q1-Q3: 10-49 months)
Performance
As reported in the abstract
Each group vs no inflammationHazard ratio (95% CI)P value
CD3-positive inflammation
5.15(3.4–7.67)
P < 0.001CD3-negative inflammation
2.44(1.31–4.55)
P > 0.01- Elevated CD3-positive T cells (≥7.8 cells/mm²): strongest independent predictor of mortality and LVEF deterioration, HR 1.037 (95% CI 1.027-1.047)
- P < 0.001
- Increased macrophage-1 antigen, CD45R0 or leukocyte function antigen-1 positive counts associated with poorer survival and ventricular function, even without elevated CD3 cells
- P < 0.01
Further findings
Additional markers identifying otherwise undiagnosed intramyocardial inflammation
- Patients with inflammation identified only by additional markers
- 26%
Dose-response
- Higher quantitative immune cell counts associated with progressively worse clinical outcomes
Original publication
Endomyocardial Biopsy-Based Inflammatory Phenotypes Predict Outcomes in Virus-Negative Dilated and Inflammatory Cardiomyopathy. JACC Heart Fail. Published 30 June 2026. doi:10.1016/j.jchf.2026.103185
Summarised from the published abstract; every number is checked against it