Prognostic Significance of Endomyocardial Biopsy in Patients With Congestive Cardiomyopathy

Breithardt, Günter; Kuhn, H.; Knieriem, H.-J.

doi:10.1007/978-3-642-66772-5_22

Cited by 11 publications

(2 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kunkel and his coresearchers [ 166,1751 documented an impressive relationship between increasing myocyte size and connective tissue content with progressive severity of COCM, as well as establishing that later in the disease there is an increase in quantitative ultrastructural change. In support of these findings, other researchers have published a positive correlation between severity and the patient's prognosis [ 162,176,1771. A positive correlation between increasing degrees of ultrastructural change and worsening hemodynamic function has also been documented by Geschwind et a1 [ 1781, as well as by Zebe et a1 [ 1791.…”

Section: Diagnosis Of Dilated (Congestive) Cardiomyopathymentioning

confidence: 52%

Endomyocardial biopsy: A review of the literature

Przybojewski

1985

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

A review of the literature relating to endomyocardial biopsy (EMB) is presented. This is considered important at this time since EMB is being utilized with increasing frequency, particularly for the diagnosis of myocarditis. The development of the technique is briefly outlined. Emphasis is placed on the clinical application of EMB in the various primary cardiomyopathies (dilated, hypertrophic, restrictive, and obliterative), the infiltrative secondary cardiomyopathies (amyloidosis, sarcoidosis, hemochromatosis), myocarditis, as well as such conditions as adriamycin cardiotoxicity, cardiac transplant rejection, and Kawasaki disease. More controversial application of EMB in primary mitral valve prolapse (Barlow's syndrome), idiopathic ventricular arrhythmias, and the elucidation of the enigmatic finding of angina with angiographically normal coronary arteries is detailed. Experience with immunological and biochemical investigation of biopsy material, as well as with virus isolation and drug assays in the myocardium, is alluded to. Complications encountered with this procedure are also discussed, and its future role is contemplated.

show abstract

Section: Diagnosis Of Dilated (Congestive) Cardiomyopathymentioning

confidence: 52%

Endomyocardial biopsy: A review of the literature

Przybojewski

1985

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

show abstract

“…The diagnosis of COCM is mostly made in an advanced stage of the disease, as the presymptomatic manifestation of COCM is unclear. Therefore, following previous studies (Kuhn et al, 1974a(Kuhn et al, , 1975Loogen and Kuhn, 1977;Breithardt et al, 1978) endomyocardial catheter biopsy (EMCB) was used in an attempt to get more information on prognosis of COCM. Clinical and haemodynamic data as well as biopsy results were correlated to the clinical course of the patients.…”

Section: Introductionmentioning

confidence: 99%

Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy (COCM)Supported in part by grant of Deutsche Forschungsgemeinschaft, SFB 30 Kardiologie Düsseldorf.

Kuhn

Breithardt

Knieriem

et al. 1978

Postgraduate Medical Journal

Self Cite

View full text Add to dashboard Cite

SummaryIn order to find evidence of prognosis and of presymptomatic manifestation of congestive cardiomyopathy (COCM) in fifty-eight patients, the extent of morphological changes of endomyocardial catheter biopsy (EMCB), clinical and haemodynamic data were correlated to the clinical course. In addition, clinical, haemodynamic, angiographic, morphological and His-bundle electrographic studies were performed in patients with left bundle branch block (LBBB), normal left ventricular end-diastolic volume, and normal coronary arteries (n = 43).Related to a 10-year mortality rate of 70%o from the onset of symptoms, COCM is one of the most severe heart diseases. Endomyocardial catheter biopsy (EMCB) allowed clear prognostic separation in patients with COCM and seems to be of diagnostic value in patients with only slightly enlarged hearts and in patients with a short history of symptoms. The studies also revealed much evidence that at least some patients with LBBB, normal left ventricular enddiastolic volume (LVEDV) and normal coronary arteries exhibit an early stage of COCM. In these patients especially EMCB with severe changes of heart muscle cells and/or impaired left ventricular function may indicate subsequent COCM. So that there is now a new indication for performing EMCB. IntroductionThe clinical course of patients with congestive cardiomyopathy can vary considerably, i.e. it can be fast or slow or may even show transient remission (Breithardt, Kuhn and Knieriem, 1978;

show abstract

Determinants of end‐stage idiopathic dilated cardiomyopathy: A multivariate analysis of 104 patients

Romeo¹,

Pelliccia²,

Cianfrocca³

et al. 1989

Clinical Cardiology

View full text Add to dashboard Cite

Summary:Our purpose in this study was to investigate the correlation of clinical, electrocardiographic, hemodynamic, and histopathologic features at diagnosis with the long-term prognosis in 104 patients with idiopathic dilated cardiomyopathy to determine which factors are the independent determinants of the end-stage disease. During a mean follow-up of 3.8rfr3.5 years, 35 patients (33%) died, 14 (13%) suddenly and 21 (20%) from congestive heart failure. Univariate analysis of survival curves disclosed that clinical and electrocardiographic variables at diagnosis were similar in survivors and nonsurvivors. On the contrary, patients who subsequently died had higher mean right atrial pressure (p=O.OOOl), right ventricular end-diastolic pressure (p =0.0061), mean pulmonary artery pressure (p=O.OOOl), and left ventricular systolic (p=0.0049) and end-diastolic (p=0.0021) pressure than survivors. They also exhibited larger left ventricular eod-diastolic (p=0.0046) and end-systolic (p=0.0027) volumes, lower ejection fraction (p=O.OOOl), and a greater proportion had severe mitral regurgitation (p=0.0095). Univariate analysis of histologic findings collected in a subgroup of patients referred since 1984 revealed a mild degree of myocellular hypertrophy to be associated with a poor prognosis (p=O.O217). Multivariate analysis selected only mean right atrial pressure (p=0.0022), ejection fraction (p=0.0089), and endsystolic volume (p =0.0265) as independent determinants of cardiac death. Our results suggest that cardiac catheteri- zation is mandatory for risk stratification of patients with idiopathic dilated cardiomyopathy, since it allows the assessment of hemodynamic, angiographic, and histopathologic features helpful in identifying patients with a poor prognosis.

show abstract

Prognostic Significance of Endomyocardial Biopsy in Patients With Congestive Cardiomyopathy

Cited by 11 publications

References 35 publications

Endomyocardial biopsy: A review of the literature

Endomyocardial biopsy: A review of the literature

Prognosis and possible presymptomatic manifestations of congestive cardiomyopathy (COCM)Supported in part by grant of Deutsche Forschungsgemeinschaft, SFB 30 Kardiologie Düsseldorf.

Determinants of end‐stage idiopathic dilated cardiomyopathy: A multivariate analysis of 104 patients

Contact Info

Product

Resources

About