| EMB |
Detailed information on cardiac tissue architecture, including myocardial cell death, scars, fibrosis, disarrays, cardiomyocyte changes, pathological vascular conditions, granulomas and inflammatory cell differentiation Possibility of histological and molecular analysis Clinical validation Conclusive diagnosis of causative reasons for many CV diseases, eg, myocarditis and dilated cardiomyopathy Evaluation of heart transplant
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Sample size inadequacy and biopsy artefacts Interpretative mistakes on behalf of pathologists Limited to focal biopsy area at one point time (mainly limited to RV) Failure to reflect tissue heterogeneity Invasive and costly technique Associated with pain and risk for patients Difficult to repeat (not ideal for monitoring disease and response to drugs over time) Failure to reflect tissue heterogeneity
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| Fluid-based assays |
Isolation of intact cells and many biological molecules from many biological fluids Mirror of cardiac tissue heterogeneity and dynamics Sources of non-invasive biomarkers Less expensive, quick and easily repeatable tests Minimal pain/risk Potential early diagnosis Potential real-time monitoring of CV disease progression and individual drug response
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Lack of standardised protocols Management of small amounts and easily degradable materials after harvesting Need to extremely sensitive and accurate tests Absence of clinical validation
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