Among 314 patients having cardiac transplantation, the clinical and morphologic diagnoses were congruent in 87% and incongruent in 13%, with most incongruity occurring in non-ischemic cardiomyopathy.
Observational (n=314)
No
While clinical and morphologic diagnoses in cardiac transplant recipients are highly congruent overall (87%), significant incongruity exists in specific non-ischemic cardiomyopathies, highlighting the limitations of clinical diagnosis in these subsets.
Cardiac transplantation (CT) has been one of the great medical advances of the last nearly 50 years. We studied the explanted hearts of 314 patients having CT at Baylor University Medical Center Dallas from 1993 to 2012, and compared the morphologic diagnoses to the clinical diagnoses before CT. Among the 314 patients the morphologic and clinical diagnoses were congruent in 272 (87%) and incongruent in 42 (13%). Most of the incongruity occurred among the 166 patients with non-ischemic cardiomyopathy (non-IC) (36/166 22%), and of that group the major incongruity occurred among the patients with hypertrophic cardiomyopathy (7/17 41%), non-compaction left ventricular cardiomyopathy (NCLVC) (3/3 100%), mononuclear myocarditis (3/3 100%), arrhythmogenic right ventricular cardiomyopathy (ARVC) (4/4 100%), and cardiac sarcoidosis (8/8 100%). The phrase "non-IC" is a general term that includes several subsets of cardiac diseases and simply means "insignificant narrowing of 1 or more of the epicardial coronary arteries," but it does not specify the specific cause of the heart failure leading to CT. A number of cardiac illustrations are provided to demonstrate the morphologic variability occurring among the patients with IC and non-IC.
Roberts et al. (Tue,) conducted a observational in Cardiac transplantation (n=314). Morphologic examination of explanted hearts vs. Clinical diagnosis was evaluated on Congruence between clinical and morphologic diagnoses. Among 314 patients having cardiac transplantation, the clinical and morphologic diagnoses were congruent in 87% and incongruent in 13%, with most incongruity occurring in non-ischemic cardiomyopathy.
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