{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T17:17:12Z","timestamp":1782580632804,"version":"3.54.5"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2017,10,25]],"date-time":"2017-10-25T00:00:00Z","timestamp":1508889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the influence of endomyocardial biopsy (EMB)-proven intramyocardial inflammation on mortality in patients with cardiac transthyretin amyloid (ATTR) or amyloid light-chain (AL) amyloidosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We included 54 consecutive patients (mean age 68.83\u2009\u00b1\u20099.59\u2009years; 45 men) with EMB-proven cardiac amyloidosis. We followed up patients from first diagnostic biopsy to as long as 36\u2009months (mean 11.5\u2009\u00b1\u200912\u2009months) and compared their outcome with information on all-cause mortality with or without proof of inflammation on EMB. Intramyocardial inflammation was assessed by quantitative immunohistology. Patients suffering from amyloidosis revealed a significant poor prognosis with proof of intramyocardial inflammation in contrast to those without inflammation (log-rank P\u2009=\u20090.019). Re-grouping of patients indicated AL amyloidosis to have a significant impact on all-cause mortality (log-rank P\u2009=\u20090.012). The detailed subgroup analysis showed that patients suffering from AL amyloidosis with intramyocardial inflammation have a significantly worse prognosis compared with AL amyloidosis without inflammation and ATTR with or without inflammation, respectively (log-rank P\u2009=\u20090.014, contingency Fisher's exact test, P\u2009=\u20090.008).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study reports for the first time a high incidence (48.1%) of intramyocardial inflammation in a series of patients with EMB-proven cardiac amyloidosis and could show that in patients with AL amyloidosis, intramyocardial inflammation correlated significantly with increased mortality. Our data have a direct clinical impact because one can hypothesize that additional immunomodulating\/anti-inflammatory treatment regimens in patients with biopsy-proven inflammation of heart muscle tissue could be beneficial for patients suffering from cardiac AL amyloidosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.1039","type":"journal-article","created":{"date-parts":[[2017,10,25]],"date-time":"2017-10-25T01:52:38Z","timestamp":1508896358000},"page":"751-757","source":"Crossref","is-referenced-by-count":68,"title":["Intramyocardial Inflammation Predicts Adverse Outcome in Patients with Cardiac AL Amyloidosis"],"prefix":"10.1093","volume":"20","author":[{"given":"Christine S.","family":"Siegismund","sequence":"first","affiliation":[{"name":"Institute for Cardiac Diagnostics and Therapy (IKDT) , Berlin 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,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Gross","sequence":"additional","affiliation":[{"name":"Institute for Cardiac Diagnostics and Therapy (IKDT) , Berlin ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich","family":"Fruhwald","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Medical University Graz , Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Center for Cardiology - Cardiology I and Center for Thrombosis and Hemostasis, University Medical Center Mainz , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Center for Cardiology - Cardiology I and Center for Thrombosis and Hemostasis, University Medical Center Mainz , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III - Cardiology, Angiology and Intensive Care Medicine, University Hospital Schleswig-Holstein , Kiel ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhold P.","family":"Linke","sequence":"additional","affiliation":[{"name":"amYmed, Reference Center of Amyloid Diseases , Martinsried ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz-Peter","family":"Schultheiss","sequence":"additional","affiliation":[{"name":"Institute for Cardiac Diagnostics and Therapy (IKDT) , Berlin 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