Fluorescence of damaged myocardium in endomyocardial biopsy specimens for the evaluation of cardiac transplantation.
Sections stained with hematoxylin-eosin from 138 endomyocardial biopsy specimens were examined in a Zeiss epifluorescent ultraviolet microscope for fluorescence indicative of myocardial injury. The biopsy specimens had been obtained from cardiac transplant recipients for routine follow-up evaluation or due to clinically suspected episodes of rejection. Yellow fluorescence and/or granularity of necrotic myofibers (with normal myocardium appearing olive green to yellow-brown), as reported in autopsy series, was observed in 22 of our specimens, for which the results of staining with hematoxylin-eosin and/or trichrome were found to contain areas of fiber fluorescence that were not recognized by staining with hematoxylin-eosin or trichrome. In some areas in an additional 13 specimens, the fiber damage seen on ultraviolet examination was greater than that suspected on the basis of the light microscopic morphologic changes. In seven cases routine light microscopy revealed fiber necrosis that could not be confirmed by ultraviolet illumination study. Fluorescence of damaged myofibers under ultraviolet illumination may contribute to the detection of early or mild myocardial injury in endomyocardial biopsy specimens from cardiac transplant recipients.
D001706:Biopsy; D009202:Cardiomyopathies / Q000209:etiology / Q000473:pathology*; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D008856:Microscopy, Fluorescence; D008860:Microscopy, Ultraviolet; D009206:Myocardium / Q000473:pathology*