PMID- 15699250
OWN - NLM
STAT- MEDLINE
DCOM- 20051027
LR  - 20220330
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 111
IP  - 7
DP  - 2005 Feb 22
TI  - High prevalence of viral genomes and multiple viral infections in the myocardium 
      of adults with "idiopathic" left ventricular dysfunction.
PG  - 887-93
AB  - BACKGROUND: For a long time, enteroviruses have been considered to be the most 
      common cause of acute viral myocarditis (MC), with possible transition from MC to 
      dilated cardiomyopathy (DCM). Recent investigations have shown, however, that 
      other viruses are also frequently encountered in MC patients, suggesting that 
      persistence of various virus species may play a pathogenic role in the transition 
      from MC to DCM. The purpose of this study was to screen endomyocardial biopsies 
      (EMBs) from patients with "idiopathic" DCM for the presence of viral genomes by 
      using polymerase chain reaction (PCR) to assess the frequency of cardiac viral 
      infections that may be involved in the pathogenesis of the disease. METHODS AND 
      RESULTS: EMBs were obtained for PCR analysis from 245 consecutive patients 
      (median left ventricular ejection fraction, 35.0%; range, 9% to 59%). PCR and 
      reverse transcription-PCR were performed to detect the genomic sequences of 
      enterovirus (EV), adenovirus (ADV), human cytomegalovirus (HCMV), herpes simplex 
      virus, Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), parvovirus B19 
      (PVB19), and influenza A and B viruses. Myocardial inflammation was assessed by 
      histological and immunohistological analyses. Viral genomes could be amplified 
      from EMBs of 165 (67.4%) of the 245 DCM patients: EV=23 (9.4%), ADV=4 (1.6%), 
      PVB19=126 (51.4%), HHV-6=53 (21.6%), EBV=5 (2.0%), HCMV=2 (0.8%), including n=45 
      cases (27.3%) with multiple infections. Active or borderline myocarditis 
      according to the Dallas classification did not exist in any case. Lymphocyte and 
      macrophage infiltrates were not significantly different in virus-positive versus 
      virus-negative patients. CONCLUSIONS: Viral genomes were frequently detected in 
      EMBs of patients with systolic left ventricular dysfunction. Our data suggest 
      that myocardial persistence of various viruses, often presenting as multiple 
      infections, may play a role in the pathogenesis of DCM far more frequently than 
      suspected so far.
FAU - Kuhl, Uwe
AU  - Kuhl U
AD  - Charite-University Medicine Berlin, Campus Benjamin Franklin, Department of 
      Cardiology and Pneumology, Hindenburgdamm 30, 12200 Berlin, Germany. 
      uwe.kuehl@charite.de
FAU - Pauschinger, Matthias
AU  - Pauschinger M
FAU - Noutsias, Michel
AU  - Noutsias M
FAU - Seeberg, Bettina
AU  - Seeberg B
FAU - Bock, Thomas
AU  - Bock T
FAU - Lassner, Dirk
AU  - Lassner D
FAU - Poller, Wolfgang
AU  - Poller W
FAU - Kandolf, Reinhard
AU  - Kandolf R
FAU - Schultheiss, Heinz-Peter
AU  - Schultheiss HP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20050207
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
CIN - Circulation. 2005 Oct 11;112(15):e265; author reply e265. PMID: 16216969
MH  - Adult
MH  - Aged
MH  - Biopsy
MH  - Cardiomyopathy, Dilated/etiology/*virology
MH  - Female
MH  - *Genome, Viral
MH  - Heart/*virology
MH  - Humans
MH  - Inflammation
MH  - Male
MH  - Middle Aged
MH  - Myocarditis/virology
MH  - Polymerase Chain Reaction
MH  - Prevalence
MH  - Ventricular Dysfunction, Left/etiology/*virology
MH  - Virus Diseases/*complications/physiopathology
EDAT- 2005/02/09 09:00
MHDA- 2005/10/28 09:00
CRDT- 2005/02/09 09:00
PHST- 2005/02/09 09:00 [pubmed]
PHST- 2005/10/28 09:00 [medline]
PHST- 2005/02/09 09:00 [entrez]
AID - 01.CIR.0000155616.07901.35 [pii]
AID - 10.1161/01.CIR.0000155616.07901.35 [doi]
PST - ppublish
SO  - Circulation. 2005 Feb 22;111(7):887-93. doi: 10.1161/01.CIR.0000155616.07901.35. 
      Epub 2005 Feb 7.