Right ventricular endomyocardial biopsy. Clinicopathologic correlates in 100 consecutive patients

T. B. Nippoldt, W. D. Edwards, David Holmes, G. S. Reeder, G. O. Hartzler, H. C. Smith

Research output: Contribution to journalArticle

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Abstract

The first 100 consecutive patients to undergo right ventricular endomyocardial biopsy at the Mayo Clinic were divided retrospectively into five groups, depending on the prebiopsy clinical diagnosis, and the biopsies were reviewed histologically in a single-blind format. Group 1 consisted of 34 patients with a diagnosis of unexplained congestive heart failure and a dilated heart; of these, 4 (12%) had active myocarditis by biopsy. Of the six patients in group 2 with a clinical diagnosis of myocarditis, only one (17%) had biopsy evidence of inflammation, but two (33%) had changes that, in the clinical setting, were suggestive of cardiomyopathy. Group 3 consisted of 27 patients with dysrhythmia, syncope, or cardiac arrest but without congestive heart failure; of these, 4 (15%) had active myocarditis by biopsy, and 8 (30%) had changes that, with the clinical history, were consistent with cardiomyopathy. Group 4 included 19 patients with unexplained congestive heart failure and a nondilated heart; 4 (21%) had cardiac amyloid on biopsy. Group 5 was a diverse group of 14 patients with possible cardiac involvement by a known systemic disease; myocardial disease was documented by biopsy in 7 (50%). On the basis of these findings, we recommend endomyocardial biopsy in patients with dilated cardiomyopathy in whom myocarditis is suspected, in patients with the clinical diagnosis of active myocarditis in whom tissue documentation is indicated before treatment with anti-inflammatory or immunosuppressive drugs, in patients with clinically unexplained life-threatening dysrhythmias in whom myocarditis or cardiomyopathy may be present, and in patients with apparent hypertrophic or restrictive cardiomyopathy in whom cardiac amyloid may be present.

Original languageEnglish (US)
Pages (from-to)407-418
Number of pages12
JournalMayo Clinic proceedings
Volume57
Issue number7
StatePublished - Dec 1 1982
Externally publishedYes

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Myocarditis
Biopsy
Cardiomyopathies
Heart Failure
Amyloid
Restrictive Cardiomyopathy
Hypertrophic Cardiomyopathy
Dilated Cardiomyopathy
Syncope
Immunosuppressive Agents
Heart Arrest
Documentation
Anti-Inflammatory Agents
Inflammation
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nippoldt, T. B., Edwards, W. D., Holmes, D., Reeder, G. S., Hartzler, G. O., & Smith, H. C. (1982). Right ventricular endomyocardial biopsy. Clinicopathologic correlates in 100 consecutive patients. Mayo Clinic proceedings, 57(7), 407-418.

Right ventricular endomyocardial biopsy. Clinicopathologic correlates in 100 consecutive patients. / Nippoldt, T. B.; Edwards, W. D.; Holmes, David; Reeder, G. S.; Hartzler, G. O.; Smith, H. C.

In: Mayo Clinic proceedings, Vol. 57, No. 7, 01.12.1982, p. 407-418.

Research output: Contribution to journalArticle

Nippoldt, TB, Edwards, WD, Holmes, D, Reeder, GS, Hartzler, GO & Smith, HC 1982, 'Right ventricular endomyocardial biopsy. Clinicopathologic correlates in 100 consecutive patients', Mayo Clinic proceedings, vol. 57, no. 7, pp. 407-418.
Nippoldt TB, Edwards WD, Holmes D, Reeder GS, Hartzler GO, Smith HC. Right ventricular endomyocardial biopsy. Clinicopathologic correlates in 100 consecutive patients. Mayo Clinic proceedings. 1982 Dec 1;57(7):407-418.
Nippoldt, T. B. ; Edwards, W. D. ; Holmes, David ; Reeder, G. S. ; Hartzler, G. O. ; Smith, H. C. / Right ventricular endomyocardial biopsy. Clinicopathologic correlates in 100 consecutive patients. In: Mayo Clinic proceedings. 1982 ; Vol. 57, No. 7. pp. 407-418.
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