Rationale for Endomyocardial Biopsy of Heart Failure Patients Who Have Responded to Usual Care
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説明
Background: Endomyocardial biopsy (EBM) is the only method for histological evaluation of cardiac tissue; however, the AHA/ACC/ESC scientific statement 2007 did not recommend EBM to those who respond to usual care within 1 to 2 weeks (class IIb recommendation). Methods: We reviewed clinical charts of patients who had heart failure of unknown etiology with reduced ejection fraction (!40%) and underwent EBM as a part of diagnostic cardiac catheterization even if they well responded to usual care in Niigata University Hospital since April 2013 to March 2015. Results: Among 45 patients (54611 years old, 37 males, LVDd 63610mm LVDs 55611 mm, LVEF 28.769.0%), final diagnosis was idiopathic dilated cardiomyopathy in 39 cases (87%). EBM was crucial and helpful for final diagnosis in 6 cases (2 cases of chronic myocarditis due to collagen disease, 2 cases of arrhythmogenic right ventricular cardiomyopathy, 1 case of Fabry’s disease, and 1 case of mitochondrial cardiomyopathy). Conclusion: EBM would not be necessary for diagnosis in all of the patients who had heart failure with reduced ejection fraction and responded to usual care, but it was useful in some cases for definitive diagnosis. Comprehensive screening of secondary cardiomyopathy would be desirable before conducting EBM.
収録刊行物
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- Journal of Cardiac Failure
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Journal of Cardiac Failure 21 S200-, 2015-10-01
Elsevier BV