Significance and Value of Endomyocardial Biopsy Based on Our Own Experience

Ishibashi‐Ueda, Hatsue; Matsuyama, Taka‐aki; Ohta‐Ogo, Keiko; Ikeda, Yoshihiko

doi:10.1253/circj.cj-16-0927

Cited by 27 publications

(46 citation statements)

References 76 publications

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“…Endomyocardial biopsy is widely used as a diagnostic tool for patients with heart diseases, such as myocarditis and other cardiomyopathies, which are often difficult to diagnose by conventional radiological imaging methods [103]. The histologic examination of endomyocardial biopsy is still the gold standard for final diagnosis, such as for myocarditis and other cardiomyopathies like cardiac fibrosis, despite the continuous advancements in diagnostic and therapeutic approaches [104][105][106].…”

Section: Clinical Use Of Gal-3 As a Next-generation Biomarker In Thementioning

confidence: 99%

Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

et al. 2020

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Galectin-3 is a β-galactoside-binding lectin which is important in numerous biological activities in various organs, including cell proliferation, apoptotic regulation, inflammation, fibrosis, and host defense. Galectin-3 is predominantly located in the cytoplasm and expressed on the cell surface, and then often secreted into biological fluids, like serum and urine. It is also released from injured cells and inflammatory cells under various pathological conditions. Many studies have revealed that galectin-3 plays an important role as a diagnostic or prognostic biomarker for certain types of heart disease, kidney disease, viral infection, autoimmune disease, neurodegenerative disorders, and tumor formation. In particular, it has been recognized that galectin-3 is extremely useful for detecting many of these diseases in their early stages. The purpose of this article is to review and summarize the recent literature focusing on the biomarker characteristics and long-term outcome predictions of galectin-3, in not only patients with various types of diseases, but associated animal models.

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Section: Clinical Use Of Gal-3 As a Next-generation Biomarker In Thementioning

confidence: 99%

Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

et al. 2020

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“…Traditional EMB, established in parallel with the development of percutaneous catheter technology in 1960, is often used as the gold standard invasive technique for the differential diagnosis of many primary and secondary CV diseases including cardiomyopathies, myocarditis, infiltrative lesions, arrhythmias and drug toxicities, as well as to monitor allograft rejection after heart transplantation (table 1). 23 24 The tissue sample procured is generally a 1-4 mm of endocardium and myocardium, which allows the examination of multiple serial sections in order to evaluate endocardium, myocardium, interstitium and vasculature architecture [23][24][25] (figure 1). EMB with vascular access is an invasive highly specialised procedure that requires competence and has potential variability in execution.…”

Section: A Focus On Endomyocardial Biopsy Diagnosticsmentioning

confidence: 99%

“…Typically, EMB is performed through the jugular or, more rarely, femoral veins and is clearly associated with a low risk of procedural complications. [23][24][25] The main limits for a correct histological diagnosis are: 1) the sampling site; indeed, the site of the sampling is generally the septum to prevent complications of wall rupture, not allowing the evaluation of the whole heart, 2) the sensitivity; indeed, EMB is only valuable when it has a positive diagnosis, 3) very small tissue specimens and 4) the variety of heart diseases. [23][24][25] EMB is characterised by a good diagnostic accuracy for storage diseases (eg, amyloidosis, haemochromatosis and other storage diseases have a diffuse macroscopic and microscopic model both in systemic and localised forms with few and precise histological features such as amyloid or iron deposition), as they are widespread in all cardiac walls and the diagnosis is not influenced by the sampling site.…”

Section: A Focus On Endomyocardial Biopsy Diagnosticsmentioning

confidence: 99%

“…[23][24][25] The main limits for a correct histological diagnosis are: 1) the sampling site; indeed, the site of the sampling is generally the septum to prevent complications of wall rupture, not allowing the evaluation of the whole heart, 2) the sensitivity; indeed, EMB is only valuable when it has a positive diagnosis, 3) very small tissue specimens and 4) the variety of heart diseases. [23][24][25] EMB is characterised by a good diagnostic accuracy for storage diseases (eg, amyloidosis, haemochromatosis and other storage diseases have a diffuse macroscopic and microscopic model both in systemic and localised forms with few and precise histological features such as amyloid or iron deposition), as they are widespread in all cardiac walls and the diagnosis is not influenced by the sampling site. [23][24][25] In contrast, diagnostic accuracy is low in diseases that have a different or favourite localisation or that have different morphological aspects that are all necessary to evaluate for a complete histological diagnosis (eg, AMI, arrhythmogenic right ventricular dysplasia (ARVD)).…”

Section: A Focus On Endomyocardial Biopsy Diagnosticsmentioning

confidence: 99%

“…[23][24][25] EMB is characterised by a good diagnostic accuracy for storage diseases (eg, amyloidosis, haemochromatosis and other storage diseases have a diffuse macroscopic and microscopic model both in systemic and localised forms with few and precise histological features such as amyloid or iron deposition), as they are widespread in all cardiac walls and the diagnosis is not influenced by the sampling site. [23][24][25] In contrast, diagnostic accuracy is low in diseases that have a different or favourite localisation or that have different morphological aspects that are all necessary to evaluate for a complete histological diagnosis (eg, AMI, arrhythmogenic right ventricular dysplasia (ARVD)). [23][24][25] In fact, in ARVD, the right ventricle is more affected then the left one, but the involvement of the latter is reported in several studies; it is characterised by a progressive substitution of myocardiocytes with adipose and/or fibrous tissue and the value for histological diagnosis provides a minimum of 3% of adipose tissue and >40% of fibrous tissue, but many authors believe that a percentage of adipose tissue ranging from 5% to 20% is suspicious.…”

Section: A Focus On Endomyocardial Biopsy Diagnosticsmentioning

confidence: 99%

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Fluid-based assays and precision medicine of cardiovascular diseases: the ‘hope’ for Pandora’s box?

2019

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Progresses in liquid-based assays may provide novel useful non-invasive indicators of cardiovascular (CV) diseases. By analysing circulating cells or their products in blood, saliva and urine samples, we can investigate molecular changes present at specific time points in each patient allowing sequential monitoring of disease evolution. For example, an increased number of circulating endothelial cells may be a diagnostic biomarker for diabetic nephropathy and heart failure with preserved ejection fraction. The assessment of circulating cell-free DNA (cfDNA) levels may be useful to predict severity of acute myocardial infarction, as well as diagnose heart graft rejection. Remarkably, circulating epigenetic biomarkers, including DNA methylation, histone modifications and non-coding RNAs are key pathogenic determinants of CV diseases representing putative useful biomarkers and drug targets. For example, the unmethylated FAM101A gene may specifically trace cfDNA derived from cardiomyocyte death providing a powerful diagnostic biomarker of apoptosis during ischaemia. Moreover, changes in plasma levels of circulating miR-92 may predict acute coronary syndrome onset in patients with diabetes. Now, network medicine provides a framework to analyse a huge amount of big data by describing a CV disease as a result of a chain of molecular perturbations rather than a single defect (reductionism). We outline advantages and challenges of liquid biopsy with respect to traditional tissue biopsy and summarise the main completed and ongoing clinical trials in CV diseases. Furthermore, we discuss the importance of combining fluid-based assays, big data and network medicine to improve precision medicine and personalised therapy in this field.

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Diagnosis of isolated cardiac sarcoidosis based on new guidelines

et al. 2020

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Aims In the updated guidelines for cardiac sarcoidosis (CS) proposed by the Japanese Circulation Society (JCS), the definition of isolated CS (iCS) was established for the first time. This prompted us to examine the characteristics of patients with CS including iCS according to them by reviewing patients undergoing 18 F-fluoro-2-deoxyglucose positron-emission tomography/computerized tomography (FDG-PET/CT), compared with those with CS determined by the conventional international criteria. Methods and results From 2013 to 2019, 94 patients (61 ± 15 years, 50 female patients) with suspected CS underwent whole-body and cardiac FDG-PET/CT scanning. In contrast to 22 patients with CS based on the international criteria, 34 [27 with systemic sarcoidosis including cardiac involvement (sCS) and 7 with definitive iCS] were diagnosed with CS according to the new JCS guidelines (P = 0.012), and 60 were not (4 suspected iCS, 13 systematic sarcoidosis without cardiac involvement, and 43 no sarcoidosis). In addition to 26 of 34 patients with CS, corticosteroids were also started in 6 of 60 without CS according to clinical need. Conclusions Diagnostic yield with the new JCS guidelines was higher, with approximately 1.5-fold of the patients diagnosed with CS compared with the previous international criteria and definitive iCS accounting for approximately 20% of the whole CS cohort. In addition to 75% of the patients with sCS or definitive iCS in the updated guidelines, 10% in whom CS was not documented were also started on corticosteroids for clinical indications such as reduced cardiac function or arrhythmia.

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Significance and Value of Endomyocardial Biopsy Based on Our Own Experience

Cited by 27 publications

References 76 publications

Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

Galectin-3 as a Next-Generation Biomarker for Detecting Early Stage of Various Diseases

Fluid-based assays and precision medicine of cardiovascular diseases: the ‘hope’ for Pandora’s box?

Diagnosis of isolated cardiac sarcoidosis based on new guidelines

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