Endomyocardial Biopsy in 30 Patients With Primary Amyloidosis and Suspected Cardiac Involvement

Patricia Pellikka, David Holmes, William D. Edwards, Rick A. Nishimura, A. Jamil Tajik, Robert A. Kyle

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Thirty patients with primary amyloidosis in whom cardiac involvement was suspected underwent endomyocardial biopsies. Medical records and biopsies were reviewed and echocardiograms were interpreted by observers who were unaware of the recorded findings. Cardiac amyloidosis was documented by endomyocardial biopsy in 30 (100%) of the patients. In two patients, amyloid was present in only one of four specimens, suggesting that a minimum of four biopsy samples is necessary to eliminate the possibility of sampling error. Only 36 (55%) of 65 biopsy specimens of extracardlac tissues contained amyloid. Findings were positive for amyloidosis in 11 (58%) of 19 rectal biopsies and in 16 (52%) of 31 bone marrow biopsies. Of interest, only the endomyocardial biopsy tissues were positive for amyloid in eight (27%) of the 30 patients, among whom 12 extracardiac biopsies had been performed. Two-dimensional echocardiography was consistent with the diagnosis of amyloidosis in 19 (68%) of 28 patients and was abnormal but nonspecific In the remainder. Endomyocardial biopsy frequently provides information about cardiac involvement with amyloid when biopsy of other organs is negative or echocardiography is nonspecific.

Original languageEnglish (US)
Pages (from-to)662-666
Number of pages5
JournalArchives of Internal Medicine
Volume148
Issue number3
DOIs
StatePublished - 1988

Fingerprint

Biopsy
Amyloid
Amyloidosis
Echocardiography
Primary amyloidosis
Selection Bias
Medical Records
Bone Marrow

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Endomyocardial Biopsy in 30 Patients With Primary Amyloidosis and Suspected Cardiac Involvement. / Pellikka, Patricia; Holmes, David; Edwards, William D.; Nishimura, Rick A.; Tajik, A. Jamil; Kyle, Robert A.

In: Archives of Internal Medicine, Vol. 148, No. 3, 1988, p. 662-666.

Research output: Contribution to journalArticle

Pellikka, Patricia ; Holmes, David ; Edwards, William D. ; Nishimura, Rick A. ; Tajik, A. Jamil ; Kyle, Robert A. / Endomyocardial Biopsy in 30 Patients With Primary Amyloidosis and Suspected Cardiac Involvement. In: Archives of Internal Medicine. 1988 ; Vol. 148, No. 3. pp. 662-666.
@article{ccd57bfd404441eba00245d024cb77bc,
title = "Endomyocardial Biopsy in 30 Patients With Primary Amyloidosis and Suspected Cardiac Involvement",
abstract = "Thirty patients with primary amyloidosis in whom cardiac involvement was suspected underwent endomyocardial biopsies. Medical records and biopsies were reviewed and echocardiograms were interpreted by observers who were unaware of the recorded findings. Cardiac amyloidosis was documented by endomyocardial biopsy in 30 (100{\%}) of the patients. In two patients, amyloid was present in only one of four specimens, suggesting that a minimum of four biopsy samples is necessary to eliminate the possibility of sampling error. Only 36 (55{\%}) of 65 biopsy specimens of extracardlac tissues contained amyloid. Findings were positive for amyloidosis in 11 (58{\%}) of 19 rectal biopsies and in 16 (52{\%}) of 31 bone marrow biopsies. Of interest, only the endomyocardial biopsy tissues were positive for amyloid in eight (27{\%}) of the 30 patients, among whom 12 extracardiac biopsies had been performed. Two-dimensional echocardiography was consistent with the diagnosis of amyloidosis in 19 (68{\%}) of 28 patients and was abnormal but nonspecific In the remainder. Endomyocardial biopsy frequently provides information about cardiac involvement with amyloid when biopsy of other organs is negative or echocardiography is nonspecific.",
author = "Patricia Pellikka and David Holmes and Edwards, {William D.} and Nishimura, {Rick A.} and Tajik, {A. Jamil} and Kyle, {Robert A.}",
year = "1988",
doi = "10.1001/archinte.1988.00380030168027",
language = "English (US)",
volume = "148",
pages = "662--666",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "3",

}

TY - JOUR

T1 - Endomyocardial Biopsy in 30 Patients With Primary Amyloidosis and Suspected Cardiac Involvement

AU - Pellikka, Patricia

AU - Holmes, David

AU - Edwards, William D.

AU - Nishimura, Rick A.

AU - Tajik, A. Jamil

AU - Kyle, Robert A.

PY - 1988

Y1 - 1988

N2 - Thirty patients with primary amyloidosis in whom cardiac involvement was suspected underwent endomyocardial biopsies. Medical records and biopsies were reviewed and echocardiograms were interpreted by observers who were unaware of the recorded findings. Cardiac amyloidosis was documented by endomyocardial biopsy in 30 (100%) of the patients. In two patients, amyloid was present in only one of four specimens, suggesting that a minimum of four biopsy samples is necessary to eliminate the possibility of sampling error. Only 36 (55%) of 65 biopsy specimens of extracardlac tissues contained amyloid. Findings were positive for amyloidosis in 11 (58%) of 19 rectal biopsies and in 16 (52%) of 31 bone marrow biopsies. Of interest, only the endomyocardial biopsy tissues were positive for amyloid in eight (27%) of the 30 patients, among whom 12 extracardiac biopsies had been performed. Two-dimensional echocardiography was consistent with the diagnosis of amyloidosis in 19 (68%) of 28 patients and was abnormal but nonspecific In the remainder. Endomyocardial biopsy frequently provides information about cardiac involvement with amyloid when biopsy of other organs is negative or echocardiography is nonspecific.

AB - Thirty patients with primary amyloidosis in whom cardiac involvement was suspected underwent endomyocardial biopsies. Medical records and biopsies were reviewed and echocardiograms were interpreted by observers who were unaware of the recorded findings. Cardiac amyloidosis was documented by endomyocardial biopsy in 30 (100%) of the patients. In two patients, amyloid was present in only one of four specimens, suggesting that a minimum of four biopsy samples is necessary to eliminate the possibility of sampling error. Only 36 (55%) of 65 biopsy specimens of extracardlac tissues contained amyloid. Findings were positive for amyloidosis in 11 (58%) of 19 rectal biopsies and in 16 (52%) of 31 bone marrow biopsies. Of interest, only the endomyocardial biopsy tissues were positive for amyloid in eight (27%) of the 30 patients, among whom 12 extracardiac biopsies had been performed. Two-dimensional echocardiography was consistent with the diagnosis of amyloidosis in 19 (68%) of 28 patients and was abnormal but nonspecific In the remainder. Endomyocardial biopsy frequently provides information about cardiac involvement with amyloid when biopsy of other organs is negative or echocardiography is nonspecific.

UR - http://www.scopus.com/inward/record.url?scp=0023845404&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023845404&partnerID=8YFLogxK

U2 - 10.1001/archinte.1988.00380030168027

DO - 10.1001/archinte.1988.00380030168027

M3 - Article

C2 - 3341867

AN - SCOPUS:0023845404

VL - 148

SP - 662

EP - 666

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 3

ER -