Fowles R E, Mason J W
Ann Intern Med. 1982 Dec;97(6):885-94. doi: 10.7326/0003-4819-97-6-885.
Endomyocardial biopsy has been used more frequently over the past 10 years in an increasing number of centers in this country and abroad. When done by an experienced physician, it is as safe as routine cardiac catheterization. Although biopsy is not yet applicable in all cases of myocardial disease, many investigators have found this procedure valuable in specific circumstances, including cardiac allograft rejection, anthracycline-induced cardiomyopathy, and myocarditis. With this technique diagnoses can be made for various disorders including cardiac amyloidosis, sarcoidosis, hemochromatosis, and endomyocardial fibrosis. Although helpful in detecting an unsuspected condition or in formulating prognosis in some patients, biopsy is not diagnostically specific in patients with dilated or hypertrophic cardiomyopathy, because these diseases have no completely pathognomonic features under current examination methods. The proper practice of endomyocardial biopsy requires both technical proficiency and expert pathologic interpretation. As a research tool, biopsy will continue to yield new knowledge about myocardial disease and its treatment.
在过去十年中，心内膜心肌活检在国内外越来越多的中心得到了更频繁的应用。由经验丰富的医生进行操作时，它与常规心导管检查一样安全。尽管活检并非适用于所有心肌疾病病例，但许多研究人员发现该程序在特定情况下很有价值，包括心脏移植排斥反应、蒽环类药物诱导的心肌病和心肌炎。通过这项技术，可以对各种疾病进行诊断，包括心脏淀粉样变性、结节病、血色素沉着症和心内膜心肌纤维化。尽管活检有助于发现未被怀疑的病情或为一些患者制定预后，但对于扩张型或肥厚型心肌病患者，活检在诊断上并不具有特异性，因为在目前的检查方法下，这些疾病没有完全特征性的表现。正确进行心内膜心肌活检既需要技术熟练，也需要专家进行病理解读。作为一种研究工具，活检将继续产生有关心肌疾病及其治疗的新知识。
