Geschwind H, Perennec J, Dhainaut J F, Laurent D, Hatt P Y
Ann Med Interne (Paris). 1979;130(5):261-6.
Endomyocardial biopsies (EMB) of the left ventricle (LV) were performed during cardiac catheterization in 27 patients with apparently primary myocardiopathies (PMC). The results of optical and electron microscopy were compared with ventricular performance indices calculated from hemodynamic and cinematographic data from the left ventricle. The telediastolic pressure of the LV increases with the spread of fibrosis (r = 0.68) suggesting that it disturbs the filling of this cavity. Systolic effort is reduced as this fibrosis increases (r = 0.56), and it contributes to the changes in the pumping function of the LV, but the contractile power of the LV is altered in a less evident and less constant manner. The association of cell and fibro-elastic tissue degeneration is always accompanied by a drop in ventricular performance (p less than 0.0001). Apart from its diagnostic role, which is limited but may be of great value, the EMB can help to clarify the physiopathology of PMC and to formulate a prognosis based on more solid grounds.
对27例疑似原发性心肌病（PMC）患者在心脏导管插入术期间进行了左心室心内膜心肌活检（EMB）。将光学显微镜和电子显微镜检查结果与根据左心室血流动力学和电影造影数据计算出的心室功能指标进行了比较。左心室舒张末期压力随纤维化扩展而升高（r = 0.68），提示纤维化干扰了该腔室的充盈。随着这种纤维化增加，收缩功能降低（r = 0.56），且其促成了左心室泵血功能的改变，但左心室的收缩力以较不明显和较不稳定的方式改变。细胞与纤维弹性组织变性的关联总是伴随着心室功能下降（p小于0.0001）。除了其诊断作用（虽有限但可能具有重要价值）外，心内膜心肌活检有助于阐明原发性心肌病的生理病理学，并在更坚实的基础上制定预后。
