Endomyocardial biopsy and its significance in the diagnosis of non-coronary heart disease. Clinical observation

Abstract

Objective: to analyze the results of 27 endomyocardial biopsies in patients with various non­coronary myocardial diseases. Materials and methods. 27 diagnostic myocardial biopsies were performed in patients with the clinical picture of non­coronary myocardial diseases treated in the “A.A. Vishnevsky NMIC VMT” of the Russian Ministry of Defense in 2021–2022. There were 22 men and 5 women. The age ranged from 19 to 68 years (mean age 44 years). Results. Among 27 patients studied, inflammatory myocardial disease was detected in16 (59.2%); Inflammatory pericardial disease in 4 (14.8%); No inflammatory changes were detected in 7 (25.9%). Among 16 patients (59.2%) with inflammatory myocardial diseases, immunohistochemical signs of inflammatory myocardial disease were detected in 8 (50%) patients with cardiomyopathies (hypertrophic, arrhythmogenic). Myocarditis with wall amyloidosis was detected in 3 (18.7%). Myocardial cardiosclerosis was diagnosed in 5 (31.2%) cases. According to the results of myocardial virologic study, viral genome was detected in myocardium in 14 (51.8%) patients out of 27: in 9 (64.2%) cases this was a monoinfection with parvovirus B19, in 4 (28.5%) cases it was associated with herpes virus type 6 and in 1 case (7.14%) – a monoinfection with SARS­CoV­2 was revealed. Conclusions. The nosologic principle of selection was a prerequisite of high informativity of EMB in all 27 patients. The obtained data emphasize the necessity of EMB in those cases when clinical manifestations of the disease cannot be explained by the underlying pathology. Keywords: myocarditis, viral infection, endomyocardial biopsy, non­coronary heart disease