Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults

Endomyocardial biopsy (EMB) is the method of choice for diagnosing a wide range of myocardial diseases.Aim. To assess the rationale for diagnostic EMB in children and adults.Material and methods. Morphological and statistical analysis of 2803 diagnostic EMBs in adults (n=811) and children (n=83), in...

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Main Authors: L. B. Mitrofanova, B. E. Galkovsky, I. A. Danilova, D. S. Lebedev
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2021-12-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/4710
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author L. B. Mitrofanova
B. E. Galkovsky
I. A. Danilova
D. S. Lebedev
author_facet L. B. Mitrofanova
B. E. Galkovsky
I. A. Danilova
D. S. Lebedev
author_sort L. B. Mitrofanova
collection DOAJ
description Endomyocardial biopsy (EMB) is the method of choice for diagnosing a wide range of myocardial diseases.Aim. To assess the rationale for diagnostic EMB in children and adults.Material and methods. Morphological and statistical analysis of 2803 diagnostic EMBs in adults (n=811) and children (n=83), including those in heart transplantation (n=1909), was carried out.Results. In 231 (28%) cases, adults were diagnosed with myocarditis, of which in 6 patients — granulomatous, in 5 — eosinophilic and in 6 — lymphocytic-macrophage myocarditis after coronavirus infection. In children, myocarditis was found in 22 cases (27%). Arrhythmogenic right ventricular dysplasia took the second place in detection rate in children and adults. Immunohistochemical study revealed viral envelope protein 1 (VP1) antigen of enteroviruses in one third of myocarditis cases, and in half — other cardiotropic viruses. Dotted dystrophin expression was observed in myocarditis. A correlation was established between the perforin expression and myocarditis presence (Pearson χ2=27,8; Fisher's exact test=27,3; p=0,01).Conclusion. Analysis of diagnostic EMB results confirmed its rationale in adults and children not only for heart transplantation, but also for identifying cardiac pathology, including for myocarditis diagnosis. It has been shown that immunohistochemical study with antiviral antibodies can be considered as an alternative method for detecting viral infection. An immunohistochemical analysis for perforin and dystrophin can be recommended as additional morphological markers of myocarditis.
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spelling doaj-art-6f5b4deed22e4bedb32edb4f75289b732025-08-20T02:59:04Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-12-01261110.15829/1560-4071-2021-47103398Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adultsL. B. Mitrofanova0B. E. Galkovsky1I. A. Danilova2D. S. Lebedev3Almazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterEndomyocardial biopsy (EMB) is the method of choice for diagnosing a wide range of myocardial diseases.Aim. To assess the rationale for diagnostic EMB in children and adults.Material and methods. Morphological and statistical analysis of 2803 diagnostic EMBs in adults (n=811) and children (n=83), including those in heart transplantation (n=1909), was carried out.Results. In 231 (28%) cases, adults were diagnosed with myocarditis, of which in 6 patients — granulomatous, in 5 — eosinophilic and in 6 — lymphocytic-macrophage myocarditis after coronavirus infection. In children, myocarditis was found in 22 cases (27%). Arrhythmogenic right ventricular dysplasia took the second place in detection rate in children and adults. Immunohistochemical study revealed viral envelope protein 1 (VP1) antigen of enteroviruses in one third of myocarditis cases, and in half — other cardiotropic viruses. Dotted dystrophin expression was observed in myocarditis. A correlation was established between the perforin expression and myocarditis presence (Pearson χ2=27,8; Fisher's exact test=27,3; p=0,01).Conclusion. Analysis of diagnostic EMB results confirmed its rationale in adults and children not only for heart transplantation, but also for identifying cardiac pathology, including for myocarditis diagnosis. It has been shown that immunohistochemical study with antiviral antibodies can be considered as an alternative method for detecting viral infection. An immunohistochemical analysis for perforin and dystrophin can be recommended as additional morphological markers of myocarditis.https://russjcardiol.elpub.ru/jour/article/view/4710endomyocardial biopsyimmunohistochemical studymyocarditis
spellingShingle L. B. Mitrofanova
B. E. Galkovsky
I. A. Danilova
D. S. Lebedev
Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
Российский кардиологический журнал
endomyocardial biopsy
immunohistochemical study
myocarditis
title Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
title_full Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
title_fullStr Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
title_full_unstemmed Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
title_short Rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
title_sort rationale for endomyocardial biopsy in the diagnosis of heart disease in children and adults
topic endomyocardial biopsy
immunohistochemical study
myocarditis
url https://russjcardiol.elpub.ru/jour/article/view/4710
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AT begalkovsky rationaleforendomyocardialbiopsyinthediagnosisofheartdiseaseinchildrenandadults
AT iadanilova rationaleforendomyocardialbiopsyinthediagnosisofheartdiseaseinchildrenandadults
AT dslebedev rationaleforendomyocardialbiopsyinthediagnosisofheartdiseaseinchildrenandadults