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Viral Infections and Immunology Research / Eosinophilic Disorders and Syndromes · Journal article
Current Heart Failure Reports · August 14, 2026
A consensus or society position rather than new primary data.
This narrative review identifies endomyocardial biopsy as a diagnostic tool for immune checkpoint inhibitor myocarditis when non-invasive tests are inconclusive, and notes that CD8+ T-cell infiltrates are primary but CD68+ macrophages may indicate worse prognosis. The evidence is exploratory and observational; no controlled trials or quantified outcomes are reported.
Narrative review. Patients with suspected or confirmed immune checkpoint inhibitor–associated myocarditis.
CD8+ T cells are the primary infiltrate observed in immune checkpoint inhibitor myocarditis CD68+ macrophage presence may portend worse prognosis Endomyocardial biopsy spectrum of disease correlates with mild symptoms to fulminant presentations
No analysis of biopsy sensitivity, specificity, or safety; no performance compared to non-invasive modalities
Clinicians should consider endomyocardial biopsy when non-invasive diagnostic tools leave uncertainty about ICI myocarditis diagnosis. Macrophage infiltration may inform prognostic counseling, though evidence for therapy guidance remains emerging.
A narrative review synthesizing current understanding of endomyocardial biopsy utility in immune checkpoint inhibitor myocarditis diagnosis and prognosis, without new primary data or trials.
As stated by the source record.
Clinicians should consider endomyocardial biopsy when non-invasive diagnostic tools leave uncertainty about ICI myocarditis diagnosis. Macrophage infiltration may inform prognostic counseling, though evidence for therapy guidance remains emerging.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
To identify the role of endomyocardial biopsy in the diagnosis, prognostication, and future understanding of mechanisms for immune checkpoint inhibitor myocarditis. The use of endomyocardial biopsy in immune checkpoint inhibitor myocarditis has led to recognizing a spectrum of disease that correlates with mild symptoms to more fulminant presentations. The primary infiltrate observed is CD8+ T cells but more studies are suggesting that the presence of CD68+ macrophages may portend worse prognosis. Currently, endomyocardial biopsy still has a role in diagnosing immune checkpoint inhibitor myocarditis especially when there is uncertainty from non-invasive diagnostic tools. Emerging evidence suggests endomyocardial biopsy can help with prognosis determination and potentially even guide future cancer therapy. Future research into understanding mechanisms of immune checkpoint inhibitor myocarditis will require endomyocardial biopsy for tissue acquisition.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.