Evidence map›Paper›PMID 42598654›Full record

ArticleEuropean heart journal. Case reports2026

Myocardial immune vulnerability unmasked after treatment with immune checkpoint inhibitors: a case report.

Eduardo Zatarain-Nicolás, Laura Yousif, Francisco Diaz-Crespo, Enrique Ortega-Sollero, José Ángel Arranz, Javier Bermejo, Pilar Martín, Wouter C Meijers

Abstract readCase Reports
In one paragraph

Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Eduardo Zatarain-NicolásCardiology Department, Gregorio Marañón University Hospital, IISGM, Complutense University, Calle Doctor Esquerdo 46, Madrid 28007, Spain.ORCID https://orcid.org/0000-0002-4384-935X
Laura YousifCardiovascular Institute, Thorax Center, Department of Cardiology, Erasmus University Medical Center, Dr. Molewaterplein, Rotterdam 403015 GD, The Netherlands.ORCID https://orcid.org/0000-0001-8556-753X
Francisco Diaz-CrespoPathology Department, Gregorio Marañón University Hospital, Calle Doctor Esquerdo 46, Madrid 28007, Spain.ORCID https://orcid.org/0000-0001-5090-8488
Enrique Ortega-SolleroCentro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fernández Almagro 3, Madrid 28029, Spain.ORCID https://orcid.org/0000-0002-1489-9294
José Ángel ArranzOncology Department, Gregorio Marañón University Hospital, Calle de Maiquez 7, Madrid 28009, Spain.ORCID https://orcid.org/0000-0003-0009-2147
Javier BermejoCardiology Department, Gregorio Marañón University Hospital, IISGM, Complutense University, Calle Doctor Esquerdo 46, Madrid 28007, Spain.ORCID https://orcid.org/0000-0002-5241-2758
Pilar MartínCentro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBER-CV), Instituto de Salud Carlos III (ISCIII), Calle Monforte de Lemos, 3-5, Pabellón 11, Planta baja, Madrid 28029, Spain.ORCID https://orcid.org/0000-0002-2392-1764
Wouter C MeijersCardiovascular Institute, Thorax Center, Department of Cardiology, Erasmus University Medical Center, Dr. Molewaterplein, Rotterdam 403015 GD, The Netherlands.ORCID https://orcid.org/0000-0002-3287-6766

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Although uncommon (incidence <1%), cardiac immune-related adverse events (irAEs) associated with immune checkpoint inhibitor (ICI) therapy can be fatal. Their underlying mechanisms remain incompletely understood, although autoimmune predisposition and cross-antigen responses have been implicated. Case summary: We report the case of a young, immunologically predisposed patient with renal cell carcinoma who developed recurrent episodes of myocardial injury following an initial mild ICI-related myocarditis. Subsequent viral infections acted as triggers for repeated myocardial damage despite discontinuation of ICI therapy. Discussion: Novel immune biomarkers were identified, and distinctive findings on endomyocardial biopsy, together with tumour protein expression patterns, provided insight into the patient's heightened myocardial immune vulnerability to viral infections. This case highlights the complex interplay between ICI therapy, host immune predisposition, and viral triggers in the pathogenesis of cardiac irAEs.

Indexed as

Heart failureImmune checkpoint inhibitorsImmune related adverse eventsMyocarditisPericardial effusion

Identifiers

PMID42598654
PMCPMC13472169

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.