A rare case of Epstein-Barr virus-induced dilated cardiomyopathy

Mutlu, Halil; Alam, Manzoor; Ozbilgin, Ozlem Fidan

doi:10.1016/j.hrtlng.2009.12.012

Cited by 10 publications

(13 citation statements)

References 13 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Autoantibodies against the myocytes activate the complement system and then cause cellular cytotoxicity [5]. This causes diffuse myocyte necrosis and the remaining myocardium dilates to compensate [6].…”

Section: Discussionmentioning

confidence: 99%

Recognizing Rare Sequelae of Epstein-Barr Virus Myocarditis Leading to Dilated Cardiomyopathy and Acute Congestive Heart Failure With Multivalvular Regurgitation

Aknouk¹,

Choe²,

Osborn³

et al. 2022

Cureus

View full text Add to dashboard Cite

Myocarditis is associated with a wide range of infections, most commonly viral (cytomegalovirus), bacterial, and parasitic (Trypanosoma cruzi). Epstein-Barr virus (EBV) rarely causes myocarditis, which is a lifethreatening complication. Autoantibodies against cardiac myocytes activate the complement system and cause diffuse myocyte necrosis. Myocarditis has a variable presentation from asymptomatic to cardiogenic shock. Over time, untreated myocarditis can progress and result in dilated ventricles. Continued dilation of ventricles leads to systolic dysfunction, conduction abnormalities, ventricular arrhythmia, heart failure, valvular abnormalities, and thromboembolism. So, we are emphasizing the importance of early diagnosis and treatment of EBV to prevent mortality. This case study represents a rare case of mortality secondary to EBV infection with resultant DCM and congestive heart failure (CHF).

show abstract

Section: Discussionmentioning

confidence: 99%

Recognizing Rare Sequelae of Epstein-Barr Virus Myocarditis Leading to Dilated Cardiomyopathy and Acute Congestive Heart Failure With Multivalvular Regurgitation

Aknouk¹,

Choe²,

Osborn³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Thus, it is difficult to determine whether EBV infection is causative under certain conditions of heart failure or whether the virus is merely a bystander. Although in rare cases EBV has been implicated in acute myocarditis 49 , exacerbation of coronary events 50 and heart failure 51 , definitive evidence of causation remains elusive. Further, these studies were reliant upon detection of neutralizing antibodies for EBV in patient blood.…”

Section: Discussionmentioning

confidence: 99%

“…As such, it is difficult to determine whether EBV infection is causative under certain conditions of heart failure or whether it is merely a bystander. Although EBV has been implemented in rare cases of acute myocarditis 49 , exacerbation of coronary events 50 and heart failure 51 , definitive evidence of causation remains elusive and such studies have relied on detection of neutralizing antibodies for EBV in patient blood. Similar analyses have been conducted for B19V, with limited evidence for causation or contribution to acute and chronic cardiac disease 47 , 52 .…”

Section: Introductionmentioning

confidence: 99%

Advanced detection strategies for cardiotropic virus infection in a cohort study of heart failure patients

Hanson

Liu-Fei²,

Minato³

et al. 2022

Laboratory Investigation

View full text Add to dashboard Cite

The prevalence and contribution of cardiotropic viruses to various expressions of heart failure are increasing, yet primarily underappreciated and underreported due to variable clinical syndromes, a lack of consensus diagnostic standards and insufficient clinical laboratory tools. In this study, we developed an advanced methodology for identifying viruses across a spectrum of heart failure patients. We designed a custom tissue microarray from 78 patients with conditions commonly associated with virus-related heart failure, conditions where viral contribution is typically uncertain, or conditions for which the etiological agent remains suspect but elusive. Subsequently, we employed advanced, highly sensitive in situ hybridization to probe for common cardiotropic viruses: adenovirus 2, coxsackievirus B3, cytomegalovirus, Epstein–Barr virus, hepatitis C and E, influenza B and parvovirus B19. Viral RNA was detected in 46.4% (32/69) of heart failure patients, with 50% of virus-positive samples containing more than one virus. Adenovirus 2 was the most prevalent, detected in 27.5% (19/69) of heart failure patients, while in contrast to previous reports, parvovirus B19 was detected in only 4.3% (3/69). As anticipated, viruses were detected in 77.8% (7/9) of patients with viral myocarditis and 37.5% (6/16) with dilated cardiomyopathy. Additionally, viruses were detected in 50% of patients with coronary artery disease (3/6) and hypertrophic cardiomyopathy (2/4) and in 28.6% (2/7) of transplant rejection cases. We also report for the first time viral detection within a granulomatous lesion of cardiac sarcoidosis and in giant cell myocarditis, conditions for which etiological agents remain unknown. Our study has revealed a higher than anticipated prevalence of cardiotropic viruses within cardiac muscle tissue in a spectrum of heart failure conditions, including those not previously associated with a viral trigger or exacerbating role. Our work forges a path towards a deeper understanding of viruses in heart failure pathogenesis and opens possibilities for personalized patient therapeutic approaches.

show abstract

“…Epstein Barr viral infection is a very rare cause of dilated cardiomyopathy. 1,2 Three cases 1–3 worldwide have described the effect of the specific viral infection on the cardiac muscle by causing futile dilated cardiomyopathy. The prevalence has not been well described, but it is estimated at approximately 2% of myocarditis cases.…”

Section: Discussionmentioning

confidence: 99%

Epstein-Barr futile myocarditis requiring urgent orthotopic heart transplantation

et al. 2015

View full text Add to dashboard Cite

show abstract

A rare case of Epstein-Barr virus-induced dilated cardiomyopathy

Cited by 10 publications

References 13 publications

Recognizing Rare Sequelae of Epstein-Barr Virus Myocarditis Leading to Dilated Cardiomyopathy and Acute Congestive Heart Failure With Multivalvular Regurgitation

Recognizing Rare Sequelae of Epstein-Barr Virus Myocarditis Leading to Dilated Cardiomyopathy and Acute Congestive Heart Failure With Multivalvular Regurgitation

Advanced detection strategies for cardiotropic virus infection in a cohort study of heart failure patients

Epstein-Barr futile myocarditis requiring urgent orthotopic heart transplantation

Contact Info

Product

Resources

About