The possible role of myocardial biopsy in systemic sclerosis

The histopathological features of heart involvement in systemic sclerosis ( SSc) are not widely known. In internal and transplantation medicine, myocar dial biopsies are increasingly used to diagnose cardiomyopathies including myocarditis. In two SSc patients presenting with dyspnoea with no evidence of pulmonary involvement, the cause of the compromised heart function was s ought by myocardial biopsy. Immunohistological analysis revealed an increas ed number of CD3+ T cells indicating myocarditis in one, and increased amou nts of fibroblasts in both SSc patients. The authors think that myocardial involvement in SSe should be differentially evaluated and they propose the use of myocardial biopsies as a tool to distinguish between inflammatory an d fibrotic forms of heart involvement in SSe patients.