Myocardial biopsy: techniques and indications
Myocardial biopsy: techniques and indications
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DOI：
10.1136/heartjnl-2017-311382
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发表时间：
2018-06-01
期刊：
影响因子：
5.7
通讯作者：
Lewis, Clive
中科院分区：
文献类型：
--
作者：
Francis, Rohin;Lewis, Clive
在过去的50年里，肌内膜活检（EMB）技术已经得到了改进，现在它代表了一种安全的研究，特别是在寻找一组特定的诊断和检测移植心脏排斥反应的最有效方法时。尽管如此，它并非没有风险，其实施在不同中心之间差异很大。2007年发表的美国心脏协会（AHA），美国心脏病学会（ACC）和欧洲心脏病学会（ESC）的联合科学声明仍然是当前指南的核心，但承认大规模随机数据稀缺，一些建议是基于积累的专家意见。1然而，正如两份同期协商一致文件中的建议所表明的那样，专家们并不总是意见一致。2013年ESC心肌和心包疾病工作组的声明建议对大多数疑似心肌炎的病例进行EMB（证据等级C），2而2013年ACC/AHA心力衰竭管理指南建议在心力衰竭患者的常规评估中不应进行EMB（证据等级C）。3
The technique of endomyocardial biopsy (EMB) has been refined over the last 50 years such that it now represents a safe investigation of particular use both when looking for a specific group of diagnoses and the most effective way of detecting rejection in the transplanted heart. Nevertheless, it is not without risk and its implementation varies widely between centres.A joint scientific statement from the American Heart Association (AHA), the American College of Cardiology (ACC) and the European Society of Cardiology (ESC) published in 2007 remains the core of current guidance, but concedes that large-scale randomised data are scarce and some recommendations are based on accumulated expert opinion. 1 However, experts do not always agree, as demonstrated by recommendations in two contemporaneous consensus documents. The 2013 statement from the ESC Working Group on Myocardial and Pericardial Disease recommends EMB for the majority of cases where myocarditis is suspected (level of evidence C), 2 while the 2013 ACC/AHA Guideline for the Management of Heart Failure recommends EMB should not be performed in the routine evaluation of patients with heart failure (level of evidence C). 3