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(Circulation. 2007;116:2216-2233.)
© 2007 American Heart Association, Inc.

AHA/ACCF/ESC Scientific Statement

The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease

A Scientific Statement From the American Heart Association, the American College of Cardiology, and the European Society of Cardiology

Leslie T. Cooper, MD, FAHA, FACC; Kenneth L. Baughman, MD, FAHA, FACC; Arthur M. Feldman, MD, PhD, FAHA, FACC; Andrea Frustaci, MD; Mariell Jessup, MD, FAHA, FACC; Uwe Kuhl, MD; Glenn N. Levine, MD, FAHA, FACC; Jagat Narula, MD, PhD, FAHA; Randall C. Starling, MD, MPH; Jeffrey Towbin, MD, FAHA, FACC; Renu Virmani, MD, FACC, Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology

Key Words: AHA Scientific Statements • biopsy • transplantation • heart failure • cardiomyopathy • myocarditis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The role of endomyocardial biopsy (EMB) in the diagnosis and treatment of adult and pediatric cardiovascular disease remains controversial, and the practice varies widely even among cardiovascular centers of excellence. A need for EMB exists because specific myocardial disorders that have unique prognoses and treatment are seldom diagnosed by noninvasive testing.¹ Informed clinical decision making that weighs the risks of EMB against the incremental diagnostic, prognostic, and therapeutic value of the procedure is especially challenging for nonspecialists because the relevant published literature is usually cited according to specific cardiac diseases, which are only diagnosed after EMB. To define the current role of EMB in the management of cardiovascular disease, a multidisciplinary group of experts in cardiomyopathies and cardiovascular pathology was convened by the American Heart Association (AHA), the American College of Cardiology (ACC), and the European Society of Cardiology (ESC). The present Writing Group was charged with reviewing the published literature on the role of EMB in cardiovascular diseases, summarizing this information, and making useful recommendations for clinical practice with classifications of recommendations and levels of evidence.

The Writing Group identified 14 clinical scenarios in which the incremental diagnostic, prognostic, and therapeutic value of EMB could be estimated and compared with the procedural risks. The recommendations contained in the present joint Scientific Statement are derived from a comprehensive review of the published literature on specific cardiomyopathies, arrhythmias, and cardiac tumors and are categorized according to presenting clinical syndrome rather than pathologically confirmed disease. The ultimate intent of this document is . . . [Full Text of this Article]

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