{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T19:00:03Z","timestamp":1776538803898,"version":"3.51.2"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The authors analyzed the effects of perforin\u2010dependent infiltration on long\u2010term mortality in patients with inflammatory cardiomyopathy (\n              <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>\n              i). We previously demonstrated that left ventricular function deteriorates and progresses to substantial cardiac dysfunction in patients with perforin\u2010positive cardiac cell infiltration.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Between 2003 and 2013, 2389 consecutive patients with clinically suspected\n              <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>\n              i who underwent endomyocardial biopsies were enrolled. Endomyocardial biopsies were performed at first admission after exclusion of ischemic or valvular heart disease, and\n              <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>\n              i was confirmed in 1717 patients. Follow\u2010up was up to 10.1\u00a0years (median 0.47\u00a0years; interquartile range, 0.03\u20132.56\u00a0years) and information on vital status was obtained from official resident data files. Multivariable statistical analysis was conducted for all patients with CMi regarding significant predictors of all\u2010cause mortality or need for heart transplantation. Multiple Cox regression analysis revealed perforin above the calculated cutoff point of 2.9 cells\/mm\u00b2 as a strong predictor of impaired survival with a hazard ratio of 1.881 (95%\n              <jats:styled-content style=\"fixed-case\">confidence interval<\/jats:styled-content>\n              , 1.177\u20133.008;\n              <jats:italic>P<\/jats:italic>\n              =0.008), independent of left ventricular function and other myocardial inflammation markers (\n              <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n              3, macrophage\u20101 antigen, leukocyte function\u2013associated antigen\u20101, human leukocyte antigen\u20101, and intercellular cell adhesion molecule\u20101). Unexpectedly, male sex emerged as another strong adverse predictor of survival in\n              <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>\n              i (hazard ratio, 1.863;\n              <jats:styled-content style=\"fixed-case\">confidence interval<\/jats:styled-content>\n              , 1.096\u20133.168 [\n              <jats:italic>P<\/jats:italic>\n              =0.022]). Whereas left ventricular ejection fraction course is adversely affected by myocardial perforin, multivariate analysis indicates that left ventricular ejection fraction explains only part of the observed overall mortality.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              High perforin\u2010positive cardiac cell infiltration and male sex are independent adverse predictors of long\u2010term mortality in\n              <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>\n              i. Furthermore, exact quantification of immunohistochemically detected infiltrates is necessary to assess the prognosis.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.005352","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["High Perforin\u2010Positive Cardiac Cell Infiltration and Male Sex Predict Adverse Long\u2010Term Mortality in Patients With Inflammatory Cardiomyopathy"],"prefix":"10.1161","volume":"6","author":[{"given":"Felicitas","family":"Escher","sequence":"first","affiliation":[{"name":"Institute for Cardiac Diagnostics and Therapy (IKDT), Berlin, Germany"},{"name":"Department of Cardiology, Charit\u00e9, CVK\u2013\u2013Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"DZHK (German Center for Cardiovascular Research), partner side Berlin partner 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