title: Clinical profile of patients with advanced age and inflammatoric dilated cardiomyopathy on endomyocardial biopsy.
abstract: BACKGROUND
  Endomyocardial biopsy (EMB) is an important tool when patients with inflammatoric cardiomyopathy (DCMi) are evaluated. We aimed to assess the clinical profile of elderly patients with DCMi on EMB.
  
  
  METHODS
  Retrospective study of all consecutive patients hospitalized from January 2007 to December 2011 with clinical suspicion of DCMi undergoing EMB. Patients with evidence of DCMi on EMB (Group 1 ≥ 70 years, n = 85; Group 3 < 70 years; n = 418) were compared to patients of the same age group without evidence of DCMi on EMB (Group 2 ≥ 70 years, n = 45; Group 4 < 70 years; n = 147).
  
  
  RESULTS
  Among 24,275 patients treated at our institution during the study period, 695 had clinical suspicion of DCMi and underwent EMB; 503 (2.1%) patients had DCMi on EMB. There were more male patients in Group 1, mean age was 74 ± 2.8 years, mean ejection fraction was 38% ± 14%. On presentation, signs of hemodynamic compromise (NYHA functional class III/IV, low cardiac output/index, and low cardiac power index) were more frequent in Group 1. EMB revealed viral genome in 78% of the patients, parvovirus B19 (PVB) was frequently encountered in both age groups (Group 1: 69.4% vs. Group 2: 59.6%); detection of more than one viral genome was more frequent in Group 1 (21.2% vs. 11.2%; P = 0.02) whereas the extent of immune response was significantly lower in individuals with advanced age.
  
  
  CONCLUSIONS
  In patients ≥ 70 years with DCMi on EMB signs of hemodynamic compromise, detection of multiple viral genomes together with an overall lower extent of immune response were more frequently observed.
authors.affiliation: Department of Cardiology, Zentralklinik Bad Berka, Germany.
authors.forename: Marc-Alexander
authors.initials: MA
authors.lastname: Ohlow
authors.affiliation: Department of Cardiology, Zentralklinik Bad Berka, Germany.
authors.forename: Ting-Hui
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Institute of Pathology, Zentralklinik Bad Berka, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Institute of Pathology, Zentralklinik Bad Berka, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Saenger
authors.affiliation: Department of Cardiology, Zentralklinik Bad Berka, Germany.
authors.forename: Bernward
authors.initials: B
authors.lastname: Lauer
keywords: Advanced age; Clinical profile; Dilated cardiomyopathy; Endomyocardial biopsy; Inflammation factors