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Background-The objective of this study was to identify the prognostic indicators in patients with suspected myocarditis who underwent endomyocardial biopsy. Methods and Results-Between 1994 and 2007, 181 consecutive patients (age, 42Ϯ15 years) with clinically suspected viral myocarditis were enrolled and followed up for a mean of 59Ϯ42 months. Endomyocardial biopsies were studied for inflammation with histological (Dallas) and immunohistological criteria. Virus genome was detected by polymerase chain reaction. The primary end point was time to cardiac death or heart transplantation. In 38% of the patients (nϭ69), the Dallas criteria were positive. Immunohistological signs of inflammation were shown in 50% (nϭ91). Genomes of cardiotropic virus species were detected in 79 patients (44%). During follow-up, 22% of the patients (nϭ40) reached the primary end point. Three independent predictors were identified for the primary end point, namely New York Heart Association class III or IV at entry (hazard ratio, 3.20; 95% confidence interval,

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