The role of endomyocardial biopsy in the management of cardiovascular disease: a commentary on joint AHA/ACC/ ESC guidelines

摘要

There is no doubt that EMB is a very powerful research tool that is underutilised in clinical trials and hypothesis generating research. However, given the rnrelative rarity of situations in which there is diagnostic uncertainty after thorough clinical investigation, it would seem prudent to perform routine EMB only in clinical situations in which the diagnosis is unclear following non-invasive testing and when a tissue diagnosis is likely to substantially alter clinical management. Given the potential hazards of the technique in inexperienced hands, and the challenges of interpretation of biopsy specimens, there is also a strong argument for centralising EMB in a small number of expert centres.