[Endomyocardial biopsy as a method of surveilling adriamycin cardiac toxicity. 28 biopsies in 26 patients].

The aim of this study was to evaluate the role of endomyocardial biopsy in the surveillance of toxic, latent cardiomyopathy secondary to adriamycin (ADM) therapy, and to assess its value by comparison with non-invasive investigations such as echocardiography. Twenty six patients underwent endomyocardial biopsy and echocardiographic measurement of the fractional shortening of the left ventricular internal diameter after a total dose of 150 to 520 mg/m2 of ADM. Interstitial fibrosis was observed in 8 of the 20 interpretable cases on light microscopy (6 moderate, 2 severe). There were no cellular changes. Slight focal myofibril degeneration was observed in 8 cases, and vacuolisation corresponding to mild dilatation of the sarcoplasmic reticulum was observed in 9 cases out of the 22 technically interpretable cases on electron microscopy. In contrast to the findings of interstitial fibrosis, cellular degeneration correlated significantly with the total dose of ADM (p less than 0,01). We conclude that this histological study confirms the fact that myocardial changes are rare and slight with doses of less than 520 mg/m2 of ADM and that non-invasive techniques are adequate for follow-up until this dose is reached.