Heart 2009;95:759-760
TECHNOLOGY AND GUIDELINES
The role of endomyocardial biopsy in the management of cardiovascular disease: a commentary on joint AHA/ACC/ESC guidelines
1 The Heart Hospital, University College London, London, UK
2 IRCCS Foundation San Matteo Hospital, Pavia, Italy
Dr P Elliott, The Heart Hospital, 16–18 Westmoreland Street, London W1G 8PH, UK; perry.elliott@ucl.ac.uk
Accepted 11 November 2008
| The first 150 words of the full text of this article appear below. |
Data on the use of endomyocardial biopsy (EMB) in routine cardiological practice are scant, but anecdotal evidence suggests that its frequency varies substantially between centres. The reasons for this variation are unclear, but they almost certainly include differential access to cardiological and pathological expertise, and a lack of consensus on the risk–benefit ratio of EMB in particular clinical situations. A distinguished panel working under the auspices of the American Heart Association (AHA), American College of Cardiology (ACC) and the European Society of Cardiology (ESC) has recently produced a scientific statement on the indications for EMB.1 Refreshingly, the document’s recommendations are based, where possible, on an analysis of clinical scenarios in which EMB might be useful rather than lists of diseases that can theoretically be detected in myocardial tissue samples. The fact that the panel strongly recommended EMB in only two relatively uncommon clinical situations illustrates the urgent need for more
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