Role of Endomyocardial Biopsy in Diagnostics of Myocarditis
Endomyocardial biopsy as the cornerstone of diagnostics has been re-evaluated throughout the years, leaving unanswered questions on the precedence of it. The reported incidence of myocarditis has increased during the pandemic of coronavirus disease 2019 (COVID-19), reinforcing discussions on appropr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/9/2104 |
| _version_ | 1797489441043906560 |
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| author | Liga Vidusa Oskars Kalejs Aija Maca-Kaleja Ilze Strumfa |
| author_facet | Liga Vidusa Oskars Kalejs Aija Maca-Kaleja Ilze Strumfa |
| author_sort | Liga Vidusa |
| collection | DOAJ |
| description | Endomyocardial biopsy as the cornerstone of diagnostics has been re-evaluated throughout the years, leaving unanswered questions on the precedence of it. The reported incidence of myocarditis has increased during the pandemic of coronavirus disease 2019 (COVID-19), reinforcing discussions on appropriate diagnostics of myocarditis. By analysis of evidence-based literature published within the last demi-decade, we aimed to summarize the most recent information in order to evaluate the current role of endomyocardial biopsy in diagnostics and management of myocarditis. For the most part, research published over the last five years showed ongoing uncertainty regarding the use, informativeness, safety and necessity of performing a biopsy. Special circumstances, such as fulminant clinical course or failure to respond to empirical treatment, were reconfirmed as justified indications, with a growing applicability of non-invasive diagnostic approaches for most other cases. We concluded that endomyocardial biopsy, if performed properly and with adjunct diagnostic methods, holds a critical role for treatment correction in specific histological subtypes of myocarditis and for differential diagnosis between immune-mediated myocarditis and secondary infections due to immunosuppressive treatment. A high level of possible misdiagnosing was detected, indicating the need to review terminology used to describe findings of myocardial inflammation that did not meet Dallas criteria. |
| first_indexed | 2024-03-10T00:17:36Z |
| format | Article |
| id | doaj.art-1109519ced55459cad98f0b50cb57d35 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T00:17:36Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-1109519ced55459cad98f0b50cb57d352023-11-23T15:48:48ZengMDPI AGDiagnostics2075-44182022-08-01129210410.3390/diagnostics12092104Role of Endomyocardial Biopsy in Diagnostics of MyocarditisLiga Vidusa0Oskars Kalejs1Aija Maca-Kaleja2Ilze Strumfa3Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, LatviaDepartment of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, LatviaDepartment of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, LatviaDepartment of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, LatviaEndomyocardial biopsy as the cornerstone of diagnostics has been re-evaluated throughout the years, leaving unanswered questions on the precedence of it. The reported incidence of myocarditis has increased during the pandemic of coronavirus disease 2019 (COVID-19), reinforcing discussions on appropriate diagnostics of myocarditis. By analysis of evidence-based literature published within the last demi-decade, we aimed to summarize the most recent information in order to evaluate the current role of endomyocardial biopsy in diagnostics and management of myocarditis. For the most part, research published over the last five years showed ongoing uncertainty regarding the use, informativeness, safety and necessity of performing a biopsy. Special circumstances, such as fulminant clinical course or failure to respond to empirical treatment, were reconfirmed as justified indications, with a growing applicability of non-invasive diagnostic approaches for most other cases. We concluded that endomyocardial biopsy, if performed properly and with adjunct diagnostic methods, holds a critical role for treatment correction in specific histological subtypes of myocarditis and for differential diagnosis between immune-mediated myocarditis and secondary infections due to immunosuppressive treatment. A high level of possible misdiagnosing was detected, indicating the need to review terminology used to describe findings of myocardial inflammation that did not meet Dallas criteria.https://www.mdpi.com/2075-4418/12/9/2104myocarditisinflammatory cardiomyopathyendomyocardial biopsyCOVID-19 |
| spellingShingle | Liga Vidusa Oskars Kalejs Aija Maca-Kaleja Ilze Strumfa Role of Endomyocardial Biopsy in Diagnostics of Myocarditis Diagnostics myocarditis inflammatory cardiomyopathy endomyocardial biopsy COVID-19 |
| title | Role of Endomyocardial Biopsy in Diagnostics of Myocarditis |
| title_full | Role of Endomyocardial Biopsy in Diagnostics of Myocarditis |
| title_fullStr | Role of Endomyocardial Biopsy in Diagnostics of Myocarditis |
| title_full_unstemmed | Role of Endomyocardial Biopsy in Diagnostics of Myocarditis |
| title_short | Role of Endomyocardial Biopsy in Diagnostics of Myocarditis |
| title_sort | role of endomyocardial biopsy in diagnostics of myocarditis |
| topic | myocarditis inflammatory cardiomyopathy endomyocardial biopsy COVID-19 |
| url | https://www.mdpi.com/2075-4418/12/9/2104 |
| work_keys_str_mv | AT ligavidusa roleofendomyocardialbiopsyindiagnosticsofmyocarditis AT oskarskalejs roleofendomyocardialbiopsyindiagnosticsofmyocarditis AT aijamacakaleja roleofendomyocardialbiopsyindiagnosticsofmyocarditis AT ilzestrumfa roleofendomyocardialbiopsyindiagnosticsofmyocarditis |