Forschungsdatenbank PMU-SQQUID

PMU-Autor/inn/en

Abstract

BACKGROUND
Enteroviruses (EVs) and adenoviruses (ADVs) have been considered common causes of myocarditis and dilated cardiomyopathy. In the present study, we report on the association of parvovirus B19 (PVB19) genomes in the clinical setting of acute myocarditis.
This study included 24 consecutive patients admitted to our hospital within 24 hours after onset of chest pain. Acute myocardial infarction had been excluded in all patients by coronary angiography. Endomyocardial biopsies were analyzed by nested polymerase chain reaction/reverse transcriptase-polymerase chain reaction for EV, ADV, PVB19, human cytomegalovirus, Epstein-Barr virus, Chlamydia pneumoniae, influenza virus A and B, and Borrelia burgdorferi genomes, respectively, followed by direct sequencing of the amplification products. All patients presented with acute onset of angina pectoris and ST-segment elevations or T-wave inversion mimicking acute myocardial infarction. Mean baseline peak creatinine kinase and creatine kinase-isoenzyme fraction were 342+/-241 U/L and 32+/-20 U/L, respectively. Mean troponin T was increased to 7.5+/-15.0 ng/mL and C-reactive protein to 91+/-98 mg/mL. Eighteen patients had global or regional wall motion abnormalities (ejection fraction 62.5+/-15.5%). Histological analysis excluded the presence of active or borderline myocarditis in all but one patient. PVB19, EV, and ADV genomes were detected in the myocardium of 12, 3, and 2 patients, respectively (71%). Follow-up biopsies of virus-positive patients (11 of 17) demonstrated persistence of PVB19 genomes in 6 of 6 patients, EV genomes in 2 of 3 patients, and ADV genomes in 1 of 2 patients, respectively.
Virus genomes can be demonstrated in 71% of patients with normal coronary anatomy, clinically mimicking acute myocardial infarction. In addition to EVs and ADVs, PVB19 was the most frequent pathogen.

Useful keywords (using NLM MeSH Indexing)

Acute Disease

Adolescent

Adult

Aged

Angina Pectoris/etiology

Biopsy

Chest Pain/etiology

Coronary Angiography

DNA, Viral/analysis

DNA, Viral/genetics

Diagnosis, Differential

Echocardiography

Electrocardiography

Female

Follow-Up Studies

Heart/virology

Humans

Immunohistochemistry

Male

Middle Aged

Myocardial Infarction/complications

Myocardial Infarction/diagnosis*

Myocardial Infarction/virology

Myocarditis/complications

Myocarditis/diagnosis*

Myocarditis/virology

Myocardium/pathology

Parvoviridae Infections/complications

Parvoviridae Infections/diagnosis*

Parvoviridae Infections/virology

Parvovirus B19, Human/genetics

Parvovirus B19, Human/isolation*

purification*

Polymerase Chain Reaction

Recurrence

Viruses/genetics

Viruses/isolation*

purification*

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