Review and Perspectives

Virchows Archiv

, Volume 463, Issue 1, pp 1-5

Diagnostic use of the endomyocardial biopsy: a consensus statement

  • Gaetano ThieneAffiliated withDepartment of Cardiological, Thoracic and Vascular Sciences, University of Padua Email author 
  • , Patrick BrunevalAffiliated withDepartment of Pathology, Hopital European Georges Pompidou
  • , John VeinotAffiliated withDepartment of Pathology and Laboratory Medicine, The Ottawa Hospital
  • , Ornella LeoneAffiliated withDepartment of Pathology, S. Orsola Malpighi Hospital

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The Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology created a task force to write a consensus document on when and how endomyocardial biopsy is of help for clinicians in the diagnosis and treatment of patients with heart failure, arrhythmias, and cardiac masses. Endomyocardial biopsy is the gold standard for a definitive diagnosis in disease entities like myocarditis, cardiac allograft rejection, and infiltration/storage myocardial disorders. Use of molecular biology techniques is mandatory to obtain specific information on etiology and pathogenesis and should be carried out as an investigation complementary to histology and immunohistochemistry. Given the complexity of these investigations, endomyocardial biopsy should be performed in or in collaboration with cardiac pathology referral centers, where the whole armamentarium of pathological investigation is available, including molecular techniques. Optimal use of the endomyocardial biopsy requires clinicopathologic correlations.


Endomyocardial biopsy Molecular pathology Myocardium Pathological analysis