Endomyocardial biopsy in diagnosis of myocardial diseases

In the past years, diagnosis of myocardial diseases became less difficult. A major contribution in this direction has the recent development of diagnosis methods. One of the most recent diagnosis procedures is the endomyocardial biopsy, which manages directly through the histologic examination to establish a clear diagnosis in myocardial diseases. This method provides faithful morphological data about the pathological changes in the myocardium. The aim of our study was to underline the importance of endomyocardial biopsy in an accurate diagnosis of different cardiomyopathies. In the period of 12 years (1986-1998), in the Cardiovascular Department of the First Medical Clinic Târgu-Mureş, Romania, were admitted 137 patients suffering from different cardiomyopathies. We performed a number of more than 100 endomyocardial biopsies on 25 of them, obtaining in each case 3 to 5 samples of endomyocardial tissue from the right ventricle. In all cases the Cordis bioptome was introduced in the right ventricle via femoralis vein. The complications were minor: ventricular extrasystoles. In all cases, we succeeded to obtain enough tissue for the histopathological examination, from different areas of RV. Histologic examination showed in all cases characteristic aspects of different cardiomyopathies. helping to clarify the diagnosis. After performing Endomyocardial Biopsy, we record an important increase of dilated cardiomyopathy percentage of diagnosis, from 40% to 72%. In patients with dilated cardiomyopathy, we observed a good correlation between hemodynamical data (Ejection Fraction, Left Ventricle End-Diastolic Pressure, etc.) and the index of myocardial damage, especially the degree of interstitial fibrosis. Using this method it is possible to distinguish different types of cardiomyopathies, such as: primary dilated cardiomyopathy, eosinophilic cardiomyopathy, myocarditis, idiopathic hypertrophic cardiomyopathy. Because the complications of this procedure are insignificant, and because of its important benefit for an accurate diagnosis, we recommend to apply this method for different cardiomyopathies.