Massimo, I., Valentina, J., Marco, M., Alberto, A., Camillo, A., Andrea, B., Barbara, B., Elena, B., Emanuele, B., Francesco, C., Silvia, C., Valentino, C., Flavio, D., Cesare, D.G., Delle, G.S., Francesca, M., Beatrice, M., Fabrizio, R., Francesco, V., . . . Gianfranco, S. (2026). Inflammatory cardiomyopathy: Position paper of the Italian Society of Cardiology Working Group on cardiomyopathies and pericardial diseases in collaboration with the Italian Society of Cardiology Working Group on cardiac magnetic resonance.. International journal of cardiology. https://doi.org/10.1016/j.ijcard.2026.134249
Massimo I, Valentina J, Marco M, Alberto A, Camillo A, Andrea B, et al. Inflammatory cardiomyopathy: Position paper of the Italian Society of Cardiology Working Group on cardiomyopathies and pericardial diseases in collaboration with the Italian Society of Cardiology Working Group on cardiac magnetic resonance.. International journal of cardiology. 2026; doi: 10.1016/j.ijcard.2026.134249
Massimo I, Valentina J, Marco M, et al. Inflammatory cardiomyopathy: Position paper of the Italian Society of Cardiology Working Group on cardiomyopathies and pericardial diseases in collaboration with the Italian Society of Cardiology Working Group on cardiac magnetic resonance.[J]. International journal of cardiology. 2026. DOI: 10.1016/j.ijcard.2026.134249.
@article{massimo2026,
author = {Imazio Massimo and Jahnsen Valentina and Merlo Marco and Aimo Alberto and Autore Camillo and Barison Andrea and Bauce Barbara and Biagini Elena and Bobbio Emanuele and Cappelli Francesco and Castelletti Silvia and Collini Valentino and D'Ascenzi Flavio and De Gregorio Cesare and Grottaglie Santo Delle and Marzo Francesca and Musumeci Beatrice and Ricci Fabrizio and Venturelli Francesco and Pedrinelli Roberto and Paolillo Stefania and Perrone-Filardi Pasquale and Limongelli Giuseppe and Sinagra Gianfranco},
title = {Inflammatory cardiomyopathy: Position paper of the Italian Society of Cardiology Working Group on cardiomyopathies and pericardial diseases in collaboration with the Italian Society of Cardiology Working Group on cardiac magnetic resonance.},
journal = {International journal of cardiology},
year = {2026},
doi = {10.1016/j.ijcard.2026.134249},
note = {PMID: 41747776},
}
TY - JOUR AU - Imazio Massimo AU - Jahnsen Valentina AU - Merlo Marco AU - Aimo Alberto AU - Autore Camillo AU - Barison Andrea AU - Bauce Barbara AU - Biagini Elena AU - Bobbio Emanuele AU - Cappelli Francesco AU - Castelletti Silvia AU - Collini Valentino AU - D'Ascenzi Flavio AU - De Gregorio Cesare AU - Grottaglie Santo Delle AU - Marzo Francesca AU - Musumeci Beatrice AU - Ricci Fabrizio AU - Venturelli Francesco AU - Pedrinelli Roberto AU - Paolillo Stefania AU - Perrone-Filardi Pasquale AU - Limongelli Giuseppe AU - Sinagra Gianfranco TI - Inflammatory cardiomyopathy: Position paper of the Italian Society of Cardiology Working Group on cardiomyopathies and pericardial diseases in collaboration with the Italian Society of Cardiology Working Group on cardiac magnetic resonance. T2 - International journal of cardiology PY - 2026 DO - 10.1016/j.ijcard.2026.134249 AN - PMID:41747776 ER -
Inflammatory cardiomyopathy (iCMP) usually represents the chronic, hypokinetic phenotype within the myocarditis spectrum, characterized by persistent myocardial inflammation, systolic ventricular dysfunction, and adverse remodelling. It frequently evolves from prior acute or subacute myocarditis and is associated with significantly worse outcomes, including progression to dilated cardiomyopathy, heart failure, and arrhythmias. The condition arises from heterogeneous causes-infectious, autoimmune, or idiopathic-and may be influenced by genetic susceptibility, supporting a two-hit model in which environmental triggers interact with pathogenic variants. Diagnosis requires a multimodal approach. While clinical presentation is variable and often non-specific, cardiac magnetic resonance (CMR) provides essential tissue characterization, enabling detection of inflammation and fibrosis. Endomyocardial biopsy (EMB) remains critical for defining histologic subtype, identifying viral genomes, and guiding targeted therapy, especially in intermediate- or high-risk cases. Genetic testing assists in differentiating inherited CMPs and recognizing forms with distinctive inflammatory behavior, such as desmoplakin CMP. Management focuses on guideline-directed medical therapy for heart failure and treatment of underlying aetiologies. In biopsy-proven, virus-negative iCMP, immunosuppressive therapy may improve ventricular function and limit adverse remodelling, while antiviral strategies remain reserved for selected virus-positive cases. Arrhythmia management, including ICD implantation, is essential in patients with substantial fibrotic burden or arrhythmias. Prognosis depends on ventricular function, extent of fibrosis, viral persistence, arrhythmic burden, and recurrence of inflammatory "hot phases." Lifelong follow-up is warranted. This position paper provides a comprehensive framework for the diagnosis, risk stratification, and management of iCMP, highlighting current evidence, guideline alignment, and remaining gaps.