title: [Consensus document on endomyocardial biopsy of the Associazione per la Patologia Cardiovascolare Italiana].
abstract: The Italian Scientific Associations of Cardiologists and Cardiovascular Pathologists have produced this consensus document on the diagnostic role of endomyocardial biopsy (EMB) in terms of techniques, analysis and reporting. The document is intended for clinical cardiologists, hemodynamic experts, electrophysiologists, surgical pathologists, and cardiac surgeons. It has three main aims: a) to collocate EMB in the context of currently available tools for diagnosis of heart diseases; b) to provide recommendations for rational implementation; c) to outline key characteristics (standards) for Italian cardiology and surgical pathology centers that perform and analyze EMB. A general lack of prospective, controlled studies addressing EMB prohibited the use of traditional evidence-based recommendations that rely on classes of available evidence. Thus, it was agreed that three key points should be taken into account: a) the specific pathology to be diagnosed (or excluded); b) the existence of any alternative, non-invasive diagnostic techniques; c) the overall consequences of reaching a definite diagnosis on patients' clinical management. Accordingly, we propose recommendations for EMB based on the following levels of diagnostic value: level 1: no alternative method exists to reach a definite diagnosis that can have obvious consequences for clinical management; level 2a: no alternative method exists to reach a definite diagnosis; however, the implications for clinical management are uncertain; level 2b: no alternative method exists to reach a definite diagnosis; however, the diagnosis would not influence clinical management; level 3: an alternative method exists to reach a definite diagnosis. The second part of the document proposes current protocols for the preparation, analysis and reporting of EMB in the context of each main pathologic entity. Particular attention is given to tissue characterization and implementation of molecular tests.
authors.affiliation: Anatomia Patologica, Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Via Massarenti, 9 40138 Bologna. ornella.leone@aosp.bo.it
authors.forename: Ornella
authors.initials: O
authors.lastname: Leone
authors.forename: Claudio
authors.initials: C
authors.lastname: Rapezzi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
authors.forename: Annalisa
authors.initials: A
authors.lastname: Angelini
authors.forename: Eloisa
authors.initials: E
authors.lastname: Arbustini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bartoloni
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
authors.forename: Alida L P
authors.initials: AL
authors.lastname: Caforio
authors.forename: Fiorella
authors.initials: F
authors.lastname: Calabrese
authors.forename: Fabio
authors.initials: F
authors.lastname: Coccolo
authors.forename: Giulia
authors.initials: G
authors.lastname: d'Amati
authors.forename: Emiliano
authors.initials: E
authors.lastname: Mariesi
authors.forename: Ornella
authors.initials: O
authors.lastname: Milanesi
authors.forename: Savina
authors.initials: S
authors.lastname: Nodari
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.forename: Andrea
authors.initials: A
authors.lastname: Perkan
authors.forename: Daniela
authors.initials: D
authors.lastname: Prandstraller
authors.forename: Angela
authors.initials: A
authors.lastname: Pucci
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
authors.forename: Furio
authors.initials: F
authors.lastname: Silvestri
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Valente
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
mesh_terms: D000686:Amyloidosis / Q000473:pathology; D001706:Biopsy / Q000379:methods / Q000592:standards; D002985:Clinical Protocols; D006331:Heart Diseases / Q000139:chemically induced / Q000473:pathology*; D006338:Heart Neoplasms / Q000473:pathology; D016027:Heart Transplantation / Q000473:pathology; D006801:Humans; D019190:Iron Overload / Q000473:pathology; D028361:Mitochondrial Diseases / Q000473:pathology; D009205:Myocarditis / Q000473:pathology; D009206:Myocardium / Q000473:pathology*