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In addition, EMB can have an important complementary role to the clinical assessment in establishing the diagnosis of diverse cardiac disorders, including myocarditis, cardiomyopathies, drug-related cardiotoxicity, amyloidosis, other infiltrative and storage disorders, and cardiac tumours. Improvements in EMB equipment and the development of new techniques for the analysis of EMB samples have significantly improved diagnostic precision of EMB. The present document is the result of the Trilateral Cooperation Project between the Heart Failure Association of the European Society of Cardiology, the Heart Failure Society of America, and the Japanese Heart Failure Society. It represents an expert consensus aiming to provide a comprehensive, up-to-date perspective on EMB, with a focus on the following main issues: (i) an overview of the practical approach to EMB, (ii) an update on indications for EMB, (iii) a revised plan for HTx rejection surveillance, (iv) the impact of multimodality imaging on EMB, and (v) the current clinical practice in the worldwide use of EMB.<\/jats:p>","DOI":"10.1002\/ejhf.2190","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T15:29:23Z","timestamp":1621438163000},"page":"854-871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":214,"title":["Heart Failure Association of the ESC, Heart Failure Society of America and Japanese Heart Failure Society Position Statement on Endomyocardial Biopsy"],"prefix":"10.1093","volume":"23","author":[{"given":"Petar M.","family":"Seferovi\u0107","sequence":"first","affiliation":[{"name":"Serbian Academy of Sciences and Arts , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University , Fukuoka ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis M.","family":"McNamara","sequence":"additional","affiliation":[{"name":"Heart and Vascur Institute, University of Pittsburgh Medical Center , Pittsburgh, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsen D.","family":"Risti\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinical Center of Serbia , Belgrade ,","place":["Serbia"]},{"name":"Faculty of Medicine, University of Belgrade , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Basso","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua , Padua ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biykem","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Winters Center for Heart Failure, Cardiovascular Research Institute, Baylor College of Medicine, Michael E. 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