Kawai C, Matsumori A, Kawamura K
Annu Rev Med. 1980;31:139-57. doi: 10.1146/annurev.me.31.020180.001035.
The history, technique, complications, and evaluation of myocardial biopsy, particularly in cardiomyopathies, have been reviewed and discussed. As expected, specific histological abnormalities for the diagnosis of cardiomyopathies were hard to obtain in such small fragments of myocardium. Rather, myocardial biopsy at present provides information on the severity and prognosis of cardiomyopathies, especially those with a diffuse disease process. However, morphologic examination is definitely valuable in diagnosing cardiomyopathies, even if it merely confirms the clinical diagnosis, because none of the information presently given by any one diagnostic tool is specific enough to correctly diagnose cardiomyopathy. Endomyocardial biopsy is most useful from a diagnostic standpoint in acute cardiac rejection in transplant recipients as well as in secondary myocardial diseases: myocarditis, amyloidosis, hemosiderosis, glycogen storage disease, sarcoidosis, etc. Advances in biochemical, immunologic, and more specific morphologic analyses will increase the usefulness of myocardial biopsy in diagnosing and assessing the etiology of idiopathic cardiomyopathy.
心肌活检的历史、技术、并发症及评估，尤其是在心肌病方面，已得到回顾和讨论。不出所料，在如此小的心肌碎片中很难获得用于诊断心肌病的特定组织学异常。相反，目前心肌活检可提供有关心肌病严重程度和预后的信息，尤其是那些具有弥漫性疾病过程的心肌病。然而，形态学检查在诊断心肌病方面肯定是有价值的，即使它仅仅证实了临床诊断，因为目前任何一种诊断工具所提供的信息都不够特异，不足以正确诊断心肌病。从诊断角度来看，心内膜心肌活检在移植受者的急性心脏排斥反应以及继发性心肌疾病（如心肌炎、淀粉样变性、含铁血黄素沉着症、糖原贮积病、结节病等）中最为有用。生化、免疫及更特异的形态学分析方面的进展将提高心肌活检在诊断和评估特发性心肌病病因方面的效用。
