The results of transvenous endomyocardial biopsy can frequently be used to diagnose myocardial diseases in patients with idiopathic heart failure. Endomyocardial biopsies in 100 consecutive patients revealed a substantial incidence of myocarditis.
The results of transvenous endomyocardial biopsy can frequently be used to diagnose myocardial diseases in patients with idiopathic heart failure. Endomyocardial biopsies in 100 consecutive patients revealed a substantial incidence of myocarditis.
复制标题
经静脉心内膜心肌活检的结果通常可用于诊断特发性心力衰竭患者的心肌疾病。
作者：
J. Parrillo;H. Aretz;I. Palacios;J. Fallon;P. Block
经静脉肌内膜活检是评估心脏移植排斥反应的公认方法，但该技术对其他形式心脏疾病的临床诊断价值尚未确定。我们连续对100例患者进行了活检，没有明显的并发症。获得的病理诊断信息被认为是有用的临床医生在54和46例患者没有用。在74例病因不明的充血性心力衰竭和心脏扩张患者中，有用的病理诊断包括心肌炎、血管炎、多柔比星心肌病和充血性心肌病。在大多数有心肌炎活检结果的患者中，没有其他临床或实验室结果表明存在这种疾病，如果没有活检，心肌炎的诊断就会被忽视。在26例有缩窄性或限制性心血管生理特征临床证据的患者中，有用的活检诊断包括放射性心肌病、肌内膜纤维化、淀粉样变性或无心肌疾病;在无心肌疾病的患者中，因缩窄性心包炎进行开胸术。经静脉肌内膜活检可提供临床上有用的信息，以评估疾病的心肌。
Transvenous endomyocardial biopsy is an accepted method to evaluate cardiac transplant rejection, but the clinical diagnostic value of the technique for other forms of cardiac disease has not been established. We performed biopsies in 100 consecutive patients without significant complications. The pathologic diagnostic information obtained was judged to be useful to the clinician in 54 and not useful in 46 patients. In 74 patients with congestive heart failure of unknown etiology and a dilated heart, useful pathologic diagnoses included myocarditis, vasculitis, doxorubicin cardiomyopathy, and congestive cardiomyopathy. In most of the patients with biopsy findings of myocarditis there were no other clinical or laboratory findings indicating the presence of this disease, and the diagnosis of myocarditis would have been overlooked without a biopsy. In 26 patients in whom there was clinical evidence of constrictive or restrictive cardiovascular physiologic characteristics, useful biopsy diagnoses included radiation-induced cardiomyopathy, endomyocardial fibrosis, amyloidosis, or no myocardial disease; in the patients without myocardial disease thoracotomies were performed for constrictive pericarditis. Transvenous endomyocardial biopsy can provide clinically useful information in the evaluation of diseases of the myocardium.