Heart Failure Association, Heart Failure Society of America, and Japanese Heart Failure Society Position Statement on Endomyocardial Biopsy

Seferović, Petar; Tsutsui, Hiroyuki; McNamara, Dennis M.; Ristić, Arsen D.; Basso, Cristina; Bozkurt, Biykem; Cooper, Leslie T.; Filippatos, Gerasimos; Ide, Tomomi; Inomata, Takayuki; Klingel, Karin; Linhart, Aleš; Lyon, Alexander R.; Mehra, Mandeep R.; Polovina, Marija; Milinković, Ivan; Nakamura, Kazufumi; Anker, Stefan D.; Veljić, Ivana; Ohtani, Tomohito; Okumura, Takahiro; Thum, Thomas; Tschöpe, Carsten; Rosano, Giuseppe; Coats, Andrew J.S.; Starling, Randall C.

doi:10.1016/j.cardfail.2021.04.010

Cited by 37 publications

(21 citation statements)

References 119 publications

(129 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Endomyocardial biopsy should be considered in those with clinical deterioration, particularly if heart block or ventricular arrhythmias are present and obstructive coronary artery disease has been excluded. 83 , 108 , 109 , 110 …”

Section: Discussionmentioning

confidence: 99%

2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play

Gluckman¹,

Bhave²,

Allen³

et al. 2022

Journal of the American College of Cardiology

Self Cite

271

273

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play

Gluckman¹,

Bhave²,

Allen³

et al. 2022

Journal of the American College of Cardiology

Self Cite

271

273

View full text Add to dashboard Cite

“…The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of Berlin (ethics application number EA2/140/16). At our cardiomyopathy center, 756 consecutive patients with symptoms suggestive of myocardial disease underwent catheter-guided LV-EMB procedures in the period from January 2015 until December 2020 [17,18]. EMB samples as well as blood samples were analyzed at the Cardiopathology unit of the Institute for Pathology and Neuropathology Tübingen University Hospital.…”

Section: Patients and Study Designmentioning

confidence: 99%

The Spontaneous Course of Human Herpesvirus 6 DNA-Associated Myocarditis and the Effect of Immunosuppressive Intervention

Elsanhoury

Kühl

Stautner

et al. 2022

Viruses

Self Cite

View full text Add to dashboard Cite

Introduction: This study investigated the spontaneous clinical course of patients with endomyocardial biopsy (EMB)-proven lymphocytic myocarditis and cardiac human herpesvirus 6 (HHV6) DNA presence, and the effectiveness of steroid-based intervention in HHV6-positive patients. Results: 756 heart failure (HF) patients underwent an EMB procedure to determine the underlying cause of unexplained HF. Low levels of HHV6 DNA, detectable by nested PCR only, were found in 10.4% of the cases (n = 79) of which 62% (n = 49) showed myocardial inflammation. The spontaneous course of patients with EMB-proven HHV6 DNA-associated lymphocytic myocarditis (n = 26) showed significant improvements in the left ventricular ejection fraction (LVEF) and clinical symptoms, respectively, in 15/26 (60%) patients, 3–12 months after disease onset. EMB mRNA expression of components of the NLRP3 inflammasome pathway and protein analysis of cardiac remodeling markers, analyzed by real-time PCR and MALDI mass spectrometry, respectively, did not differ between HHV6-positive and ‑negative patients. In another cohort of patients with ongoing symptoms related to lymphocytic myocarditis associated with cardiac levels of HHV6-DNA copy numbers <500 copies/µg cardiac DNA, quantified by real-time PCR, the efficacy and safety of steroid-based immunosuppression for six months was investigated. Steroid-based immunosuppression improved the LVEF (≥5%) in 8/10 patients and reduced cardiac inflammation in 7/10 patients, without an increase in cardiac HHV6 DNA levels in follow-up EMBs. Conclusion: Low HHV6 DNA levels are frequently detected in the myocardium, independent of inflammation. In patients with lymphocytic myocarditis with low levels of HHV6 DNA, the spontaneous clinical improvement is nearby 60%. In selected symptomatic patients with cardiac HHV6 DNA copy numbers less than 500 copies/µg cardiac DNA and without signs of an active systemic HHV6 infection, steroid-based therapy was found to be effective and safe. This finding needs to be further confirmed in large, randomized trials.

show abstract

“…Acute myocarditis with high-risk presentations or fulminant myocarditis is especially important to recognize because endomyocardial biopsy and immunosuppressive treatment may be indicated. 29,30 The physical examination is directed to the assessment of filling pressures and perfusion, allowing for bedside classification of hemodynamic profile. The echocardiogram examination should focus on assessment of left and right morphology and function, presence of intracardiac thrombus, regurgitant or stenotic valvular lesions, dynamic outflow tract obstruction, and surrogate estimates of filling pressures.…”

Section: Initial Evaluation Of Cardiogenic Shockmentioning

confidence: 99%

Heart Failure-Related Cardiogenic Shock: Pathophysiology, Evaluation and Management Considerations

Abraham

Blumer

Burkhoff

et al. 2021

Journal of Cardiac Failure

View full text Add to dashboard Cite

show abstract

Heart Failure Association, Heart Failure Society of America, and Japanese Heart Failure Society Position Statement on Endomyocardial Biopsy

Cited by 37 publications

References 119 publications

2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play

2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play

The Spontaneous Course of Human Herpesvirus 6 DNA-Associated Myocarditis and the Effect of Immunosuppressive Intervention

Heart Failure-Related Cardiogenic Shock: Pathophysiology, Evaluation and Management Considerations

Contact Info

Product

Resources

About