Evidence map›Paper›PMID 40968975›Full record

ArticleEuropean journal of heart failure2025

Safety and prognostic value of left ventricular endomyocardial biopsy in dilated cardiomyopathy.

Elham Kayvanpour, Farbod Sedaghat-Hamedani, Daniel Tian Li, Ebe Amr, Ali Amr, Bernd Lahrmann, Alan Lai, Christoph Reich, Chenyang Wang, Esther Herpel and 6 more

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Article in European journal of heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

16 authors.

Elham KayvanpourDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Farbod Sedaghat-HamedaniDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Daniel Tian LiDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Ebe AmrDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Ali AmrDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Bernd LahrmannHamamatsu Tissue Imaging and Analysis Center (BIOQUANT), Heidelberg, Germany.
Alan LaiDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Christoph ReichDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Chenyang WangDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Esther HerpelTissue Bank of the National Center for Tumor Diseases (NCT), Heidelberg, Germany.
Derliz MerelesDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Lutz FrankensteinDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Niels GrabeHamamatsu Tissue Imaging and Analysis Center (BIOQUANT), Heidelberg, Germany.
Hugo A KatusDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Norbert FreyDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.
Benjamin MederDepartment of Medicine III, University of Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe 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

resultsIn 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 multivariable analyses, LV-CVF and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (hazard ratio 2.03, 95% confidence interval 1.32-3.11) were independent predictors of unfavourable outcome.

conclusionsLeft ventricular EMB is a safe diagnostic procedure. The extent of CVF in LV-EMB provides prognostic information in patients with DCM in addition to existing measures of left ventricular ejection fraction or NT-proBNP.

Indexed as

Cardiomyopathy, DilatedHeart VentriclesMyocardiumAdultAgedBiopsyCollagenDeath, Sudden, CardiacFemaleFollow-Up StudiesHumansLongitudinal StudiesMagnetic Resonance Imaging, CineMaleMiddle AgedPrognosisCollagenCollagen volume fractionDilated cardiomyopathyLeft ventricular endomyocardial biopsyOutcome

Identifiers

PMID40968975
PMCPMC12803607

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