Endomyocardiofibrosis in the Americas Collaborative Study: The EMF-SIAC Registry
Cristhian E Scatularo1, Edith Liliana Posada Martínez2, Ana C Alba3
1Department of cardiology, Sanatorio de la Trinidad de Palermo, Buenos Aires, Argentina.
Current Problems in Cardiology
|July 29, 2023
Summary
Endomyocardial fibrosis (EMF) often presents as heart failure (HF) and atrial fibrillation (AF). Diagnosis frequently occurs late, with HF management and surgery being key treatments for this restrictive cardiomyopathy.
Area of Science:
- Cardiology
- Internal Medicine
- Pathology
Background:
- Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy marked by subendocardial fibrosis and eosinophilic infiltration.
- EMF commonly manifests as heart failure (HF) or atrial fibrillation (AF).
- Immunosuppression is effective in early EMF stages but not in chronic phases.
Purpose of the Study:
- To characterize patients with endomyocardial fibrosis (EMF) across the Americas.
- To analyze clinical, biochemical, and imaging features of EMF.
- To understand the diagnostic and therapeutic approaches for EMF.
Main Methods:
- Retrospective, multicenter, cross-sectional registry study.
- Inclusion criteria: patients ≥18 years with EMF diagnosed by imaging (Mocumbi criteria).
- Analysis of clinical, biochemical, and imaging variables; endomyocardial biopsy in some cases.
Main Results:
- 54 patients included: 52% male, mean age 47 years; 87% idiopathic etiology.
- High prevalence of HF (76%), AF (35%), and ischemic stroke (15%).
- Ejection fraction ≥50% in 65%; severe mitral regurgitation in 21%; severe tricuspid regurgitation in 33%.
Conclusions:
- EMF patients exhibit a high incidence of HF, AF, and embolic events.
- Diagnosis is often delayed, with advanced stages requiring HF management and surgical intervention.
- Imaging methods are crucial for EMF diagnosis, with biopsy confirming in a subset of patients.
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