Left ventricular function and endomyocardial biopsy in early and advanced dilated cardiomyopathy

Mattos, Beatriz Piva e; Zettler, Cláudio Galleano; Pinotti, Antonio Fernando Furlan; Raudales, José Casco; Zago, Alcides José

doi:10.1016/s0167-5273(97)00289-1

Cited by 7 publications

(3 citation statements)

References 50 publications

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“…However, EMB continues to be useful for the investigation of infiltrative disorders of the myocardium, primary cardiomyopathies, myocarditis, endocardial fibrosis (as a way to help distinguish between constrictive and restrictive pathology), drug toxicity, arrhythmias, and neoplasia (figs 1, 2). [8][9][10][11][12][13][14] Although there are entities such as cardiac amyloidosis and myocarditis that can be definitively diagnosed, many disease states, such as dilated cardiomyopathy (DCM; which may be seen as a terminal structural and functional manifestation of several conditions affecting the heart, both primarily and secondarily), show non-specific histopathological features. In particular, it should be emphasised that dilated cardiomyopathy is not a histological diagnosis per se, but requires significant clinical-pathological correlation, which is essential for cardiac biopsy interpretation, because a definitive diagnosis is often not possible on the basis of morphology alone.…”

Section: Clinical Indicationsmentioning

confidence: 99%

An approach to endomyocardial biopsy interpretation

Cunningham

Veinot²,

Butany³

2006

J Clin Pathol

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The endomyocardial biopsy (EMB) remains the gold standard mode of investigation for diagnosing many primary and secondary cardiac conditions. Through a percutaneous and transvenous route, tissue fragments are generally procured from the right ventricular septum, with very few complications. Widespread use of EMB followed the development of heart transplantation as a means to follow allograft rejection. It has since been useful in helping to diagnose conditions affecting the heart, including cardiomyopathies, myocarditis, infiltrative lesions, arrhythmias, and drug toxicities. The procedure has also been used as a research tool to investigate the natural history of disease and the cardiotoxicity of new medications. This review presents an approach to the evaluation of the EMB, which is particularly directed towards those who may be asked to interpret such biopsies, but are not dedicated cardiovascular pathologists. Through a systematic evaluation of the endocardium, myocardium, interstitium, and intramural vessels, in the context of a complete clinical history, enough information can be deduced to diagnose or exclude specific conditions of clinical value.

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Section: Clinical Indicationsmentioning

confidence: 99%

An approach to endomyocardial biopsy interpretation

Cunningham

Veinot²,

Butany³

2006

J Clin Pathol

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“…Mean aCNR was significantly higher in the DCM group with low LVEF (<25%) than in the DCM group with high LVEF (≥25%). In DCM, recent studies showed that the extent of myocardial fibrosis was related to impaired LVEF, but it is sometimes difficult to evaluate the extent of myocardial fibrosis [4,5,[7][8][9][10]. This study shows that quantification of aCNR on DE MR images is a very useful diagnostic method to noninvasively evaluate the extent of myocardial fibrosis, which can impair LVEF.…”

Section: Dcm Group Versus Control Groupmentioning

confidence: 67%

“…In DCM, the interstitium is altered and collagen content is increased [1][2][3][4][5][6][7][8][9][10], leading to diastolic dysfunction [11]. The effects of a stiff cardiac interstitium on systolic performance in this patient group, however, remain unclear because reported studies have yielded conflicting results [4,5,[7][8][9][10]. In particular, the difficulty of performing accurate quantification of fibrosis and contractile function has been a major limitation of these studies [3,4,6,12,13].…”

Section: Introductionmentioning

confidence: 99%

Quantification of enhancement of left ventricular myocardium in patients with dilated cardiomyopathy using delayed enhanced MR imaging

Sueyoshi

Sakamoto

Hayashida

et al. 2009

Computerized Medical Imaging and Graphics

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The purpose is to evaluate delayed enhancement (DE) of the myocardium in patients with dilated cardiomyopathy (DCM), compared with control subjects. We also evaluated the interrelationships of DE and contractile function.DCM patients (n=42) and 14 control subjects were evaluated by DE MR imaging, acquired using a two-dimensional segmented inversion-recovery prepared gradient-echo sequence (TI=250msec), 15 minutes after intravenous administration of 0.2 mmol/kg gadolinium.For the myocardium of LV, we traced epicardial and endocardial borders, and regions of interest (ROIs) were placed in each slice. For analysis of DE images, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) of the LV myocardium were calculated. The averaged SNR (aSNR) and averaged CNR (aCNR) per slice of the LV myocardium were calculated. In the DCM group, we also evaluated the interrelationship of DE and the contractile function of the left ventricle (LV).Mean aSNR was not significantly different between the studied groups; however, mean aCNR was significantly higher in the DCM group (3.5±3.1) than in control subjects 4 (-4.1±2.1).In the DCM group, aCNR was moderately related to LV ejection fraction (LVEF) (r =0.52, P < .0001). Mean aCNR was significantly higher in the DCM group with low LVEF (<25%) (6.0±2.8) than in the DCM group with high LVEF (≥25%) (2.0±2.3).In DE MR imaging, the LV myocardium of DCM usually has high aCNR, which may suggest fibrosis. Quantification of aCNR may contribute to the diagnosis of DCM. The level of aCNR seems to correlate with LVEF. Using this technique, quantification of aCNR is objective and very useful for the diagnosis of DCM and contractile function of LV.

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Impact of diabetes mellitus on myocardial lipid deposition: An autopsy study

Nakanishi

Kato

2014

Pathology - Research and Practice

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Left ventricular function and endomyocardial biopsy in early and advanced dilated cardiomyopathy

Cited by 7 publications

References 50 publications

An approach to endomyocardial biopsy interpretation

An approach to endomyocardial biopsy interpretation

Quantification of enhancement of left ventricular myocardium in patients with dilated cardiomyopathy using delayed enhanced MR imaging

Impact of diabetes mellitus on myocardial lipid deposition: An autopsy study

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