Endomyocardial biopsy

Although endomyocardial biopsy can be used to diagnose a wide range of myocardial diseases, most are rare causes of IDC and can often be diagnosed by other means. Even the detection of an inflammatory cardiomyopathy is of limited use, given the uncertainties and inconsistencies surrounding its diagnosis using conventional light microscope criteria. Endo-myocardial biopsy may be of use in selected patients—for example, those with suspected cardiac haemochromatosis and other infiltra-tive or malignant diseases—but in general it should be confined to carefully conducted clinical trials. A number of immunohistological studies have already demonstrated increased numbers of T cells and increased expression of endothelial and interstitial MHC (major histo-

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