Special investigations of COCM: endomyocardial biopsies (morphological analysis)

Abstract

SummaryEndomyocardial tissue obtained from 237 patients clinically suspected of suffering from congestive cardiomyopathy, has been analysed histologically, histochemically and ultrastructurally. In 51%. of patients, the suspected diagnosis was morphologically confirmed and in 24-5%y, no pathological evidence of a dilated heart or other pathology was found. The results in these two groups were considered helpful.It is concluded that, even though the morphology of congestive cardiomyopathy is non-specific and the number of other pathology found is small, the continuationof investigation bybioptome is justified. Parameters such as prognosis and length of history can also be assessed. Furthermore, morphological analysis is essential to interpret accurately biochemical and other types of investigations that are being carried out on biopsy material.

Right ventricular dysfunction, late gadolinium enhancement, and female gender predict poor outcome in patients with dilated cardiomyopathy

“…RV function and volumes are parameters that are rarely taken under consideration when analyzing prognosis in patients with DCM. However, in patients with DCM, RV function has not only shown to be impaired as consequence of LV dysfunction [23,24] but histopathologically also a direct right ventricular involvement could be proved in patients with DCM [25][26][27]. In line with our results, a previous echocardiography study by Juillière Y et al [28] also found that in addition to LV-EF, RV-EF appeared to be a complementary predictor of survival in 62 patients with idiopathic DCM.…”

Current Insights and Novel Cardiovascular Magnetic Resonance-Based Techniques in the Prognosis of Non-Ischemic Dilated Cardiomyopathy

“…Independent predictors of all causes of mortality are an indexed left ventricular end-diastolic volume (LVEDVi) on CMR > 120.5 mL/m 2 and the presence of more than three segments with midwall fibrosis [23]. Juillière et al identified in right ventricular ejection fraction (RVEF) an independent predictor of all-cause mortality and a modest predictor of hospitalization due to heart failure (HF) in patients with DCM [24] because of direct right ventricular involvement [24][25][26]. Another parameter that could be evaluated by CMR is the left atrial volume index (LAVi), as a sensitive barometer of LV filling pressure and an important predictor of transplant-free survival and HF risk [27].…”

Clinical experience with two‐dimensional echocardiography to guide endomyocardial biopsy

“…The technique has proven useful for the diagnosis and prognosis of primary and secondary myocardial disease (Bristow er al., 1978(Bristow er al., , 1981Kunkel er al., 1978;Nippoldt et al, 1982;Olsen, 1978;Shirey et al, 1978) and the management of heart trans-plant rejection (Caves et al, 1973. The ability to diagnose and adequately treat primary myocarditis has added a new significance to endomyocardial biopsy (Fontes et al, 198 1 ;Mason et al, 1980;Zee-Cheng et al, 1984).…”