{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:02:34Z","timestamp":1790514154962,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Endomyocardial biopsy (EMB) has an important role in determining the pathogenesis of new-onset acute heart failure (new-AHF) when noninvasive testing is impossible. However, data on safety and histopathologic outcomes in patients requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective, multicenter cohort of patients undergoing EMB while requiring VA-ECMO for new-AHF between 1990 and 2020 was compared with a cohort of nontransplant related biopsies not requiring VA-ECMO. Primary end point of the study was to determine the safety of EMB. Additionally, we describe the underlying pathogenesis causing new-AHF based on histopathologic examination of the samples obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 23 patients underwent EMB while requiring VA-ECMO (10.0%), 125 (54.3%) during an unplanned admission, and 82 (35.7%) in elective setting. Major complications occurred in 8.3% of all procedures with a significantly higher rate in patients requiring VA-ECMO (26.1% versus 8.0% versus 3.7%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.003) predominately due to the occurrence of sustained ventricular tachycardia or need of resuscitation (13.0% versus 3.2% versus 1.2%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.02). EMB led to a histopathologic diagnosis in 78.3% of the patients requiring VA-ECMO which consisted primarily of patients with myocarditis (73.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>EMB in patients requiring VA-ECMO can be performed albeit with a substantial risk of major complications. The risk of the procedure was offset by a histopathologic diagnosis in 78.3% of the patients, which for the majority consisted of patients with myocarditis. The important therapeutic and prognostic implications of establishing an underlying pathogenesis causing new-AHF in this population warrant further refinement to improve procedural safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.121.008387","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T05:01:16Z","timestamp":1628053276000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Safety of Endomyocardial Biopsy in New-Onset Acute Heart Failure Requiring Veno-Arterial Extracorporeal Membrane Oxygenation"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6340-2590","authenticated-orcid":true,"given":"Robert M.A.","family":"van der Boon","sequence":"first","affiliation":[{"name":"Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9919-3732","authenticated-orcid":true,"given":"Wijnand K.","family":"den Dekker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiaan L.","family":"Meuwese","sequence":"additional","affiliation":[{"name":"Department of Intensive Care (C.d.U., C.L.M.), Erasmus Medical Center Rotterdam, the Netherlands."},{"name":"Department of Cardiology and Intensive Care, Utrecht Medical Center, the Netherlands (C.L.M., J.J.v.d.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Intensive Care, Maastricht University Medical Center, the Netherlands (R.L., T.S.R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9699-4860","authenticated-orcid":true,"given":"Jan H.","family":"von der Th\u00fcsen","sequence":"additional","affiliation":[{"name":"Department of Pathology (J.H.v.d.T.), Erasmus Medical Center Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina C.","family":"Constantinescu","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier C.","family":"Manintveld","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijs S.R.","family":"Delnoij","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Intensive Care, Maastricht University Medical Center, the Netherlands (R.L., T.S.R.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris. 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