Safety and Prognostic Value of Left Ventricular Endomyocardial Biopsy in Dilated Cardiomyopathy

作者：Elham Kayvanpour, Farbod Sedaghat‐Hamedani, Daniel Tian Li, E. Amr, Ali Amr, Bernd Lahrmann, Alan Lai, Christoph Reich, Chenyang Wang, Esther Herpel, Derliz Mereles, Lutz Frankenstein, Niels Grabe, H. A. Katus, Norbert Frey, Benjamin Meder · 发表于：European Journal of Heart Failure · 年份：2025 · DOI：10.1002/ejhf.70019 · 被引用次数：1 · 研究领域：Viral Infections and Immunology Research、Cardiomyopathy and Myosin Studies、Eosinophilic Disorders and Syndromes

AIMS: The need to perform endomyocardial biopsy (EMB) in patients with non-ischaemic dilated cardiomyopathies (DCM) is debated. Here we sought to determine the extent of left ventricular collagen volume fraction (LV-CVF) in DCM patients and to evaluate it as a prognostic marker. METHODS AND RESULTS: In this retrospective longitudinal study, we included 524 patients with suspected DCM who underwent left ventricular EMB (LV-EMB) as a part of their clinical work-up. LV-CVF was quantified using automated image processing of high-resolution scans of LV-EMB. Deep phenotyping was performed including assessment of late gadolinium enhancement on cardiac magnetic resonance imaging. Endpoints were (i) composite endpoint of heart failure-related death, sudden cardiac death, aborted sudden cardiac death (appropriate implantable cardioverter-defibrillator shock, reported sustained ventricular tachycardia, or cardiopulmonary resuscitation), or cardiac transplantation, and (ii) all-cause mortality. LV-EMB was associated with 0.76% major and 2.1% minor complications. No death occurred due to EMB. LV-CVF could be reliably quantified using Bayesian classification. During a median follow-up of 43.2 months (2084 patient-years), 48 patients with LV-CVF >32% and 14 patients with LV-CVF ≤32% reached the composite endpoint (log-rank p < 0.0001). A total of 62 patients reached the endpoint all-cause mortality, from which 38 presented with LV-CVF >32% and 17 with LV-CVF ≤32% (log-rank p = 0.009). In mu...