{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:46:57Z","timestamp":1790214417075,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,11,26]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Active myocarditis is characterized by large heterogeneity of clinical presentation and evolution. This study describes the characteristics and the long-term evolution of a large sample of patients with biopsy-proven active myocarditis, looking for accessible and valid early predictors of long-term prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      From 1981 to 2009, 82 patients with biopsy-proven active myocarditis were consecutively enrolled and followed-up for 147\u00b1107 months. All patients underwent clinical and echocardiographic evaluation at baseline and at 6 months. At this time, improvement\/normality of left ventricular ejection fraction (LVEF), defined as a LVEF increase &gt; 20 percentage points or presence of LVEF\u226550%, was assessed. At baseline, left ventricular dysfunction (LVEF&lt;50%) and left atrium enlargement were independently associated with long-term heart transplantation\u2013free survival, regardless of the clinical pattern of disease onset. At 6 months, improvement\/normality of LVEF was observed in 53% of patients. Persistence of New York Heart Association III to IV classes, left atrium enlargement, and improvement\/normality of LVEF at 6 months emerged as independent predictors of long-term outcome. Notably, the short-term reevaluation showed a significant incremental prognostic value in comparison with the baseline evaluation (baseline model versus 6 months model: area under the curve 0.79 versus 0.90,\n                      <jats:italic>P<\/jats:italic>\n                      =0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Baseline left ventricular function is a marker for prognosis regardless of the clinical pattern of disease onset, and its reassessment at 6 months appears useful for assessing longer-term outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.113.003092","type":"journal-article","created":{"date-parts":[[2013,10,2]],"date-time":"2013-10-02T00:05:27Z","timestamp":1380672327000},"page":"2384-2394","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":187,"title":["Long-Term Evolution and Prognostic Stratification of Biopsy-Proven Active Myocarditis"],"prefix":"10.1161","volume":"128","author":[{"given":"Marco","family":"Anzini","sequence":"first","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Merlo","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gastone","family":"Sabbadini","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Barbati","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gherardo","family":"Finocchiaro","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Pinamonti","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Salvi","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Perkan","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Di Lenarda","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Bussani","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozef","family":"Bartunek","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Department, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, \u201cOspedali Riuniti di Trieste\u201d and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"3","article-title":"Myocarditis. 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