左室内和右室内内心脏内膜活检的比较评估:并发症率和诊断性能的差异
Ali Yilmaz1, Ingrid Kindermann, Michael Kindermann
1Division of Cardiology, Robert-Bosch-Krankenhaus, Stuttgart, Germany. ali.yilmaz@rbk.de
Circulation
|August 18, 2010
概括
与单心室活检相比,双心室内心肌组织活检 (EMB) 为心肌炎和心肌病提供了更高的诊断产量. 左心室 (LV) 和右心室 (RV) 两种EMB都是安全的,双心室EMB优化了诊断准确性.
科学领域:
- 心脏病学 心脏病学
- 病理学 病理学 病理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 内心肌活检 (EMB) 是诊断心肌炎和非缺血性心肌病的黄金标准.
- 这项研究评估了左心室 (LV),右心室 (RV) 和双心室EMB的并发症风险和诊断性能.
研究的目的:
- 为了比较选择性LV-EMB,选择性RV-EMB和双心室EMB的诊断产量和安全性.
- 评估EMB在疑似心肌炎和来源不明的心肌病患者的有效性.
主要方法:
- 这是一项两中心对755名怀疑患有心肌炎或非缺血性心肌病的患者进行的研究.
- 在冠状动脉血管造影后,患者接受了选择性LV-EMB,选择性RV-EMB或双心室EMB.
- 心血管磁共振 (CMR) 与晚期加多增强 (LGE) 在71.5%的患者中进行.
主要成果:
- 主要并发症的发生率很低:LV-EMB为0.64%,RV-EMB为0.82%.
- 与选择性EMB (67.3%) 相比,双胞胎EMB取得了显著更高的诊断结果 (79.3%).
- 在LV样本 (18.7%) 和RV样本 (7.9%) 中诊断出心肌炎与双心室EMB; 73.4%的心肌炎显示在两个心室.
结论:
- 当经验丰富的干预医生进行时,LV-EMB和RV-EMB是安全的程序.
- 双胞胎EMB优化了心肌炎和心肌病的诊断产量.
- 针对CMR-LGE区域的活检并没有增加心肌炎诊断率.
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