{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:25:16Z","timestamp":1787034316313,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the clinical characteristics of immune checkpoint inhibitors (ICIs)-related myocarditis and the differences between mild and severe cases, aiming to provide evidence for early identification and stratified management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 74 patients diagnosed with ICIs-related myocarditis at our hospital from April 2020 to April 2024 were retrospectively enrolled. According to the *Chinese Expert Consensus on the Surveillance and Management of Immune Checkpoint Inhibitor-Related Myocarditis (2020 Edition)* and CTCAE 5.0 criteria, patients were divided into mild group (n=49) and severe group (n=25). The two groups were compared in terms of demographic characteristics, clinical manifestations, laboratory tests, auxiliary examinations, concomitant irAEs, treatment, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The time of onset in the severe group was significantly earlier than that in the mild group [23 days (18, 85) vs. 80 days (48, 132), P\u00a0=\u00a00.004]. Severe group more frequently presented with multisystem involvement: incidences of myasthenia (56.0% vs. 6.1%), dyspnea (24.0% vs. 0), and ptosis (16.0% vs. 0) were significantly higher (all P&amp;lt;0.05). Levels of cardiac biomarkers (cTnT\/I, CK, NT-proBNP) and liver enzymes (ALT, AST) were markedly elevated (all P&amp;lt;0.01). Electrocardiographic ST-T segment changes (56.0% vs. 10.2%) and conduction blocks (32.0% vs. 4.1%) were more common in the severe group. Echocardiography showed higher rates of regional wall motion abnormality (28.0% vs. 6.1%) and pericardial effusion (28.0% vs. 6.1%) in the severe group. The severe group also had higher rates of concomitant myositis (68.0% vs. 40.8%), hepatitis (28.0% vs. 6.1%), and neurotoxicity (32.0% vs. 2.0%) (all P&amp;lt;0.05). Regarding treatment, 100% of the severe group received glucocorticoids (vs. 28.6%), 60.0% required intravenous immunoglobulin, and 28.0% needed respiratory support. Regarding outcomes, all patients in the mild group improved, while the mortality rate in the severe group was 32.0% (8\/25).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with severe ICIs-related myocarditis are characterized by early onset, multisystem involvement, marked elevation of cardiac enzymes, prominent electrocardiographic\/echocardiographic abnormalities, frequent concomitant irAEs, and high mortality. Clinicians should be highly vigilant for patients presenting with early myasthenia, conduction blocks, or markedly elevated CK\/cTn, and promptly initiate intensified immunosuppressive therapy to improve prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1904778","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:37:09Z","timestamp":1787031429000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics analysis of immune checkpoint inhibitors-related myocarditis"],"prefix":"10.3389","volume":"17","author":[{"given":"Rui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Hebei North University","place":["Zhangjiakou, 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