Parvovirus B19 in Endomyocardial Biopsy of Patients With Idiopathic Dilated Cardiomyopathy: Foe or Bystander?

Hjalmarsson, Clara; Liljeqvist, Jan‐Åke; Lindh, Magnus; Karason, Kristjan; Bollano, Entela; Oldfors, Anders; Andersson, Bert

doi:10.1016/j.cardfail.2018.07.466

Cited by 20 publications

(22 citation statements)

References 12 publications

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“…Sustained severe cardiac inflammation, especially in the setting of acute B19V infection, might lead to cardiomyocyte necrosis 33 . How B19V persistence in the heart affects clinical outcomes is still under discussion 34 , 35 . The aetiological role of B19V infection in the development of myocarditis is also unclear, given that B19V is often found in myocardial autopsy samples from individuals without myocarditis or DCM 36 , 37 .…”

Section: Pathogenesismentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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Inflammatory cardiomyopathy is defined as myocarditis in association with cardiac dysfunction and ventricular remodelling 1,2. Despite extensive research and improved diagnosis and understanding of the pathogenesis of inflammatory cardiomyopathy, this disorder is still associated with a poor prognosis when complicated by left ventricular (LV) dysfunction, heart failure (HF) or arrhythmia 3. Furthermore, fulminant myocarditis, a rare, sudden and severe cardiac inflammation, is one of the main causes of cardiogenic shock in young adults 4,5. Prompt diagnosis and specific treatment strategies are needed to reduce mortality and the need for heart transplantation in these patients 4,5. Many questions remain unanswered regarding the pathogenesis of inflammatory cardiomyopathy and the role of the viral infection, the immune system, the host genetic background and the environment in disease progression and prognosis. These gaps in knowledge highlight the need for advanced experimental systems that can better model the human immune system and the need to improve the characterization and classification of the patients, for example, with the use of phenomapping and phenomics, which involve detailed evaluation of immune status, viral presence and/or other biomarkers. In this Review, we discuss the available evidence and identify the gaps in our understanding of the pathogenesis, diagnosis, treatment and prognosis of myocarditis and inflammatory cardiomyopathy, appraise the available animal and cell models of these conditions and propose future directions for the field. We discuss the role

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Section: Pathogenesismentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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“…Full-text review resulted in a further 62 articles being excluded due to an unsuitable subject, no relevant endpoint, no control group, or no survival data or because they were a review or from the same study as another report. is resulted in 10 articles that included 1006 patients with suspected myocarditis or dilated cardiomyopathy con rmed by EMB being selected for inclusion in the meta-analysis: (1) Why et al [8], (2) Figulla et al [9], (3) Fujioka et al [10], (4) Caforio et al [11], (5) Kindermann et al [12], (6) Nowalany-Kozielska et al [13], 7Tebbe et al [14], (8) Karatolios et al [15], (9) Kuethe et al [16], and (10) Hjalmarsson et al [17]. e screening process is shown in Figure 1 and the characteristics of the selected studies are provided in Tables 1 and 2. e quality scores of the 10 studies ranged from 7 to 9 ( Table 3), indicating that they were all high-quality studies according to the NOS.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

“…Only 3 of the 10 studies provided HR values and 95% CIs. erefore, we used Tierney's method [17] (as recommended by the Cochrane Handbook) to extract the number of people, the number of events, and the Kaplan-Meier curve from each article, allowing us to calculate the HR value and its interval. Five of the studies were from Germany, while one was from each of Japan, Italy, the United Kingdom, Poland, and Switzerland, and none of the studies were included in other publications.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

Long-Term Prognosis of Suspected Myocarditis and Cardiomyopathy Associated with Viral Infection of the Myocardial Tissue: A Meta-Analysis of Cohort Studies

Chen

Guo

Zhang

et al. 2019

Cardiovascular Therapeutics

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Aim. Myocarditis and cardiomyopathy impose a substantial economic burden on society. Many studies have examined the effects of various predictors on the prognosis of these diseases, such as the left ventricular systolic function, the New York Heart Association glomerular filtration rate, the QT interval, and the presence of viruses. In the present study, we conducted a meta-analysis of cohort studies to investigate the significance of the presence of viruses in the myocardial tissue on the prognosis of these diseases. Methods. The Embase, PubMed, and Cochrane library databases were searched for relevant literature that had been published between January 1, 1964 and August 14, 2018. The inclusion criteria were patients over 18 years of age, suspected myocarditis or dilated cardiomyopathy, accepted myocardial biopsy, and the detection of virus in the myocardial tissue. Results. In total, 10 studies met the inclusion criteria. These studies included 1006 patients with suspected myocarditis or idiopathic heart disease for whom the primary endpoint was all-cause death, heart transplant, or re-hospitalization due to fatal arrhythmia and heart failure. There was no significant difference in the prognosis of virus-positive and virus-negative patients with myocarditis or dilated cardiomyopathy confirmed by endomyocardial biopsy (EMB) [hazard ratio (HR) = 1.40, 95% confidence interval (CI) = 0.93–2.12, P=0.11]. However, virus-negative patients had a better prognosis following nonspecific treatment (HR = 1.40, 95% CI = 1.06–1.86, P=0.02) and right ventricular biopsy (HR = 2.08, 95% CI = 1.07–4.04, P=0.03). Conclusions. The presence of a virus did not worsen the long-term prognosis of patients with suspected myocarditis or dilated cardiomyopathy. However, virus-positive patients who did not undergo specific treatment or who underwent right ventricular biopsy did have a worse prognosis. Thus, the early diagnosis of the presence of viral infection in the myocardium will improve the prognosis of patients.

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“…The clinical impact of vasculotropic erythroparvovirus B19 in the heart is still under discussion [45][46][47]. Erythroparvovirus B19 can hibernate in endothelial precursor cells after primary infection.…”

Section: Viral Infectionmentioning

confidence: 99%

Cardiomyopathies - The special entity of myocarditis and inflammatory cardiomyopathy

Escher¹,

Kühl²,

Laßner³

et al. 2019

J Cardiol Cardiovasc Med

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Parvovirus B19 in Endomyocardial Biopsy of Patients With Idiopathic Dilated Cardiomyopathy: Foe or Bystander?

Cited by 20 publications

References 12 publications

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

Long-Term Prognosis of Suspected Myocarditis and Cardiomyopathy Associated with Viral Infection of the Myocardial Tissue: A Meta-Analysis of Cohort Studies

Cardiomyopathies - The special entity of myocarditis and inflammatory cardiomyopathy

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