Recommendations for the evaluation of myocardial recovery Recommendations Class Level References Pathological evaluation of myocardial tissue obtained during apical coring to identify treatable aetiologies of heart failure is recommended. I C [410, 411] In patients with LT-MCS with non-ischaemic cardiomyopathy, optimized medical heart failure therapy to promote myocardial recovery is recommended. I C [405] Adding a selective beta-2 adrenergic agonist to conventional HF therapy is not recommended. III B Routine screening of patients with LT-MCS with non-ischaemic cardiomyopathy for myocardial recovery by echocardiography, including the ramp test, is recommended. I B [397, 412] Before explantation, invasive haemodynamic examination of patients with LT-MCS is recommended. I B [398] Cardiopulmonary exercise testing may be considered prior to the decision about LT-MCS explantation. IIb C [413] Screening for recurrence of heart failure after LT-MCS explantation is recommended. I C [414, 415] LT-MCS: long-term mechanical circulatory support.