Clinical Significance of Viral Genome Persistence in the Myocardium of Patients with Dilated Cardiomyopathy

Nowalany-Kozielska, Ewa; Kozieł, Monika; Domal-Kwiatkowska, Dorota; Wojciechowska, Celina; Jacheć, Wojciech; Kawecki, Damian; Tomasik, Andrzej; Przywara-Chowaniec, Brygida; Węglarz, Ludmiła; Reichman-Warmusz, Edyta; Wojnicz, Romuald

doi:10.1159/000443375

Cited by 11 publications

(12 citation statements)

References 23 publications

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“…Oxidative stress also contributes to viral pathogenesis. Nowalany-Kozielski et al, (10*) found no significant difference between the presence of viral genomes in the biopsies studied and the immunohistochemistry results. They concluded that a high prevalence of viral genome in the myocardium of patients with dilated cardiomyopathy may not influence their long-term political outcome as manifested by death or cardiac transplantation.…”

Section: Introductionmentioning

confidence: 85%

Viral myocarditis

Rose¹

2016

Current Opinion in Rheumatology

123

103

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Purpose of the review This article traces the pathways leading from viral infection of the heart by coxsackievirus B3 to autoimmune myocarditis in its various manifestations. Recent findings Myocarditis can be induced by a number of different infectious agents and represents a significant cause of death especially in young individuals. Following infection patients may develop lymphocytic, eosinophilic, or giant cell/granulomatous myocardial inflammation. It can lead to infectious dilated cardiomyopathy, a disease frequently requiring cardiac transplantation. Although acute viral myocarditis is frequently sub-clinical and recovery may be spontaneous, treatment of chronic myocarditis is presently unsatisfactory. Ongoing disease may be due to persistent virus in the heart or to immunopathic attack. Depending on the etiology, treatment may be antiviral or immunosuppressive. Endomyocardial biopsy is proving of value in determining etiology and deciding future therapy. A great deal of information about the pathogenesis of myocarditis has been gained from experimental models in rodents using heart disease induced by infection using coxsackievirus B3 or by immunization with cardiac myosin. Summary Treatment of myocarditis is still problematic and may depend on etiologic diagnosis to distinguish infectious from immune mediated disease. Both pathogenic mechanisms may co-occur in individual patients. In the future, treatment may depend upon endomyocardial biopsy, immunohistologic testing, improved imaging, and molecular genetic analysis for providing more precise diagnoses.

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Section: Introductionmentioning

confidence: 85%

Viral myocarditis

Rose¹

2016

Current Opinion in Rheumatology

123

103

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“…The continued inflammatory response and fibroblast mobilization that subsequently causes fibrosis without viral replication in a later phase of the CVB‐induced myocarditis model suggests the possibility of virus‐induced anti‐cardiac autoimmunity against damaged myocardial proteins . Although it remains controversial, several recent studies have favoured the view that the presence of virus genomes is of no prognostic relevance to patients with DCM . In addition, an organ‐specific autoimmune disease may, without any viral infection, trigger sustained myocardial inflammation in cardiomyopathic patients .…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of the presence of macrophages in endomyocardial biopsies of patients with dilated cardiomyopathy

Nakayama

Sugano

Yokokawa

et al. 2017

European J of Heart Fail

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“…In contrast, others report no significant difference in survival between B19V‐associated DCM and virus‐negative DCM patients . Importantly, viral load was very low (23 copies/µg DNA), which could be indicative of a latent infection . Only one study showed that the viral load of B19V is not related to an adverse long‐term outcome .…”

Section: Prognostic Relevance Of Myocardial Parvovirus B19mentioning

confidence: 96%

“…Viral persistence is associated with deterioration of LV function and viral clearance with LV improvement in viral‐positive DCM patients . In contrast, others report no significant difference in survival between B19V‐associated DCM and virus‐negative DCM patients . Importantly, viral load was very low (23 copies/µg DNA), which could be indicative of a latent infection .…”

Section: Prognostic Relevance Of Myocardial Parvovirus B19mentioning

confidence: 96%

Relevance of cardiac parvovirus B19 in myocarditis and dilated cardiomyopathy: review of the literature

Verdonschot

Hazebroek

Merken

et al. 2016

European J of Heart Fail

118

121

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Over the last decade, parvovirus B19 (B19V) has frequently been linked to the pathogenesis of myocarditis (MC) and its progression towards dilated cardiomyopathy (DCM). The exact role of the presence of B19V and its load remains controversial, as this virus is also found in the heart of healthy subjects. Moreover, the prognostic relevance of B19V prevalence in endomyocardial biopsies still remains unclear. As a result, it is unclear whether the presence of B19V should be treated. This review provides an overview of recent literature investigating the presence of B19V and its pathophysiological relevance in MC and DCM, as well as in normal hearts. In brief, no difference in B19V prevalence is observed between MC/DCM and healthy control hearts. Therefore, the question remains open whether and how cardiac B19V may be of pathogenetic importance. Findings suggest that B19V is aetiologically relevant either in the presence of other cardiotropic viruses, or when B19V load is high and/or actively replicating, which both may maintain myocardial (low-grade) inflammation. Therefore, future studies should focus on the prognostic relevance of the viral load, replicative status and virus co-infections. In addition, the immunogenetic background of MC/DCM patients that makes them susceptible to develop heart failure upon presence of B19V should be more thoroughly investigated.

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Clinical Significance of Viral Genome Persistence in the Myocardium of Patients with Dilated Cardiomyopathy

Cited by 11 publications

References 23 publications

Viral myocarditis

Viral myocarditis

Clinical impact of the presence of macrophages in endomyocardial biopsies of patients with dilated cardiomyopathy

Relevance of cardiac parvovirus B19 in myocarditis and dilated cardiomyopathy: review of the literature

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