Endomyocardial Biopsy: One Center's Report About Its Role

ABSTRACT

BACKGROUND AND OBJECTIVES: Cardiomyopathy is a common cause of heart failure, yet it is sometimes difficult to determine its exact etiology. Endomyocardial biopsy (EMBx) has been considered to be one of the important diagnostic modalities for unexplained cardiomyopathy. The aim of this study was to analyze the diagnostic value of EMBx. SUBJECTS AND METHODS: 30 patients (M F=26 4, mean age 41+/-11 yrs) who underwent EMBx since 1992 at St. Mary's hospital were enrolled. The patients were classified into 4 groups by their clinical manifestations as follows Group I 11 patients with left ventricular hypertrophy (LVH) of an unknown etiology and suspicious of having infiltrative disease on their non-invasive tests, Group II 15 patients with heart failure of an unknown etiology and rapid progression, Group III 2 patients with heart failure and peripheral eosinophilia, Group IV 2 patients with suspicious arrhythmogenic right ventricular dysplasia and cardiac mass. RESULTS: EMBx confirmed the diagnosis in 8 of 30 cases (26.7%). In Group I, 3 patients were confirmed to have amyloidosis (27.3%). In Group II, 2 patients were diagnosed as having lymphocytic myocarditis (13.3%). In Group III, all of 2 patients (100%) were diagnosed as eosinophilic myocarditis. In Group IV, 1 patient was confirmed to have cardiac metastasis from esophageal cancer. The diagnostic rate was higher for Group III than for Group II (p=0.007). There were no complications related with EMBx. CONCLUSION: EMBx may be a useful tool to confirm the causes of cardiomyopathy in selected patients.