{
  "abstract": "BACKGROUND: Endomyocardial biopsy (EMB) remains the gold standard for diagnosing acute myocarditis (AM); however, its prognostic value has not been fully established. We investigated the prognostic impact of EMB, with a focus on fulminant myocarditis (FM). METHODS AND RESULTS: We included 841 AM patients across 7 hospitals who were categorized having undergone EMB (n=268) or not (n=573). The primary outcome was in-hospital death; the secondary outcome was a composite of all-cause death, cardiac transplantation, or left ventricular assist device implantation. In-hospital mortality was lower in the EMB group (6.3% vs. 11.5%; P=0.019), with a similar reduction in the EMB group among patients with FM (11.3% vs. 23.7%; P=0.002), despite a higher rate of extracorporeal membrane oxygenation. During a median follow-up of 447 days, the composite outcome was also lower in the EMB group among patients with FM (P=0.031). In multivariable analyses, EMB was independently associated with lower in-hospital mortality in both the overall cohort and the FM subgroup. Outcomes did not differ substantially across histopathologic subtypes, although patients with giant cell myocarditis had a worse prognosis. CONCLUSIONS: In patients with AM, EMB was associated with lower in-hospital mortality and improved long-term outcomes, particularly among those with FM. Further well-designed prospective studies are warranted to evaluate the clinical impact of EMB and its potential role in improving outcomes.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "Junho Hyun"
    },
    {
      "name": "Kyung-Hee Kim"
    },
    {
      "name": "Minjung Bak"
    },
    {
      "name": "Hyukjin Park"
    },
    {
      "name": "In-Cheol Kim"
    },
    {
      "name": "Mi-Na Kim"
    },
    {
      "name": "Sang Eun Lee"
    },
    {
      "name": "Jeong Hoon Yang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8jyaq7xfgv4ge.bib",
  "cited_by": 0,
  "doi": "10.1253/circj.cj-26-0349",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0349/_article",
  "id": "8jyaq7xfgv4ge",
  "issns": [
    "1347-4820",
    "1346-9843"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0349/_article",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2705|Viral Infections and Immunology Research"
    ]
  ],
  "openalex": "W7212034984",
  "pdf_url": "https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0349/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8jyaq7xfgv4ge.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:24Z",
      "native_id": "10.1253/circj.cj-26-0349",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0349/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Viral Infections and Immunology Research",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Endomyocardial Biopsy and Clinical Outcomes in Acute Myocarditis ― Multicenter Cohort Study ―",
  "title_text": "Endomyocardial Biopsy and Clinical Outcomes in Acute Myocarditis ― Multicenter Cohort Study ―",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:24Z",
  "url": "https://research.draconitic.com/paper/8jyaq7xfgv4ge",
  "venue": "Circulation Journal",
  "versions": []
}