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Pathological findings in 2300 consecutive endomyocardial biopsies
G L Winters1, M R Costanzo-Nordin
1Department of Pathology, Loyola University Medical Center, Maywood, Illinois.
Summary
Endomyocardial biopsies (EMBs) are crucial for heart transplant rejection surveillance and diagnosing native heart conditions. This study clarifies the diagnostic yield of EMBs, highlighting common findings in both transplant recipients and patients with native heart disease.
Area of Science:
- Cardiology
- Pathology
- Transplant Medicine
Background:
- Endomyocardial biopsy (EMB) is a key diagnostic tool for heart transplant rejection surveillance and evaluating native heart diseases.
- The diagnostic spectrum and incidence of findings from EMBs in heart failure and cardiac transplant settings require detailed analysis.
Purpose of the Study:
- To clarify the spectrum and incidence of diagnoses obtained through endomyocardial biopsies.
- To analyze the diagnostic yield of EMBs in heart allograft recipients versus patients with native heart disease.
Main Methods:
- Retrospective analysis of 2300 consecutive endomyocardial biopsies performed over 2.5 years.
- Categorization of biopsies based on indication: rejection surveillance in heart allograft recipients or evaluation of native heart disease.
Main Results:
- Of 2300 EMBs, 79.9% were for rejection surveillance, with 29.1% positive for rejection (mild to severe).
- 20.1% of EMBs were for native heart disease, with 64.5% showing abnormalities including myocyte hypertrophy, fibrosis, and myocarditis.
- Other findings included Quilty effect, ischemia, cardiotoxicity, amyloidosis, and various other conditions.
Conclusions:
- EMBs provide valuable diagnostic information in both heart transplantation and native heart disease evaluation.
- Pathologists need specialized expertise to interpret diverse morphological findings from EMBs, given overlapping clinical presentations.