Behzadnia Neda, Sharif-Kashani Babak, Ahmadi Zargham Hossein, Naghashzadeh Farah, Dorudinia Atosa, Jahangirifard Alireza, Hamarz Hamoun, Abbasi Payam
Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Egypt Heart J. 2021 Mar 25;73(1):29. doi: 10.1186/s43044-021-00154-9.
Definite diagnosis of cardiomyopathy types can be challenging in end-stage disease process. New growing data have suggested that there is inconsistency between echocardiography and pathology in defining type of cardiomyopathy before and after heart transplantation. The aim of the present study was to compare the pre-heart transplant echocardiographic diagnosis of cardiomyopathy with the results of post-transplant pathologic diagnosis.
In this retrospective cross-sectional clinicopathological study, 100 consecutive patients have undergone heart transplantation in Masih-Daneshvari hospital, Tehran, Iran, between 2010 and 2019. The mean age of patients was 40 ± 13 years and 79% of patients were male. The frequency of different types of cardiomyopathy was significantly different between two diagnostic tools (echocardiography versus pathology, P < 0.001). On the other hand, in 24 patients, the results of echocardiography as regard to the type of cardiomyopathy were inconsistent with pathologic findings.
Based on the findings of the present study, it could be concluded that there is a significant difference between echocardiographic and pathologic diagnosis of cardiomyopathy; therefore, it is necessary to use additional tools for definite diagnosis of cardiomyopathy like advanced cardiac imaging or even endomyocardial biopsy before heart transplantation to reach an appropriate treatment strategy.
在终末期疾病进程中,明确诊断心肌病类型可能具有挑战性。新出现的数据表明,在心脏移植前后,超声心动图与病理学在心肌病类型定义方面存在不一致。本研究的目的是比较心脏移植前心肌病的超声心动图诊断与移植后病理诊断结果。
在这项回顾性横断面临床病理研究中,2010年至2019年间,伊朗德黑兰马西赫 - 丹内什瓦里医院连续100例患者接受了心脏移植。患者的平均年龄为40±13岁,79%的患者为男性。两种诊断工具(超声心动图与病理学)之间不同类型心肌病的频率存在显著差异(P<0.001)。另一方面,在24例患者中,超声心动图关于心肌病类型的结果与病理结果不一致。
基于本研究的结果,可以得出结论,心肌病的超声心动图诊断与病理诊断之间存在显著差异;因此,有必要在心脏移植前使用额外的工具来明确诊断心肌病,如先进的心脏成像甚至心内膜心肌活检,以制定合适的治疗策略。