Related Experiment Videos
Endomyocardial biopsy diagnosis of small vessel disease: a clinicopathologic study
1Albert Einstein College of Medicine, Department of Pathology, Bronx, NY 10461.
Insights
Small vessel disease, identified via endomyocardial biopsy, is more prevalent in women and linked to hypertension. Severe small vessel disease is often associated with chest pain in patients.
Area of Science:
- Cardiology
- Pathology
Background:
- Endomyocardial biopsy is a diagnostic tool for heart conditions.
- Small vessel disease (SVD) is a potential finding in cardiac biopsies.
- Understanding SVD's prevalence and associations is crucial for patient management.
Purpose of the Study:
- To investigate the prevalence of small vessel disease in patients undergoing endomyocardial biopsy.
- To correlate SVD with clinical signs, symptoms, and patient demographics.
- To explore the relationship between SVD, hypertension, and chest pain.
Main Methods:
- Retrospective review of clinical histories from 191 patients.
- Correlation of biopsy findings (presence and severity of SVD) with clinical data.
- Statistical analysis of demographic and symptomatic associations with SVD.
Main Results:
- Small vessel disease was present in 61% of biopsies, more common in females (67%) than males (56%).
- Hypertension was associated with a twofold increased likelihood of SVD.
- Chest pain was significantly more frequent in patients with SVD, especially severe SVD.
Conclusions:
- Endomyocardial biopsy reveals small vessel disease is common, particularly in women and hypertensive patients.
- Severe small vessel disease is strongly linked to chest pain, suggesting a potential etiological role.
Abstract:
We reviewed the clinical history of 191 patients undergoing endomyocardial biopsy and correlated signs and symptoms of heart disease with the presence or absence of small vessel disease. Idiopathic congestive heart failure (78%), arrhythmia (35%), and chest pain (25%) were the most frequent indications for biopsy. Small vessel disease was noted in 61% of the biopsies (67% female, 56% male): 10% severe, 36% moderate, and 15% mild small vessel disease. Patients with hypertension were twice as likely to have small vessel disease than those without hypertension. Of the 27 females with hypertension, 85% had small vessel disease, 67% with either severe or moderate small vessel disease. Small vessel disease was almost twice as frequent in patients with chest pain compared to patients without chest pain. Chest pain was significantly more common in patients with severe small vessel disease than in those with normal small vessels. Of all patients with chest pain, 18% had severe small vessel disease; however, of 20 patients with severe small vessel disease, 45% had chest pain. This analysis suggests that small vessel disease seen in endomyocardial biopsy is more common in women and is related to hypertension. When severe, it is likely to be associated with atypical chest pain.