Dengue and the heart

Araiza-Garaygordobil, Diego; García-Martínez, Carlos Eduardo; Burgos, Lucrecia María; Saldarriaga, Clara; Liblik, Kiera; Mendoza, Iván; Martínez‐Sellés, Manuel; Scatularo, Cristhian E; Farina, Juan; Baranchuk, Adrián

doi:10.5830/cvja-2021-033

Cited by 30 publications

(58 citation statements)

References 22 publications

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“…Enteroviruses, adenoviruses and Zika virus are able to infect cardiomyocytes directly, parvovirus B19 can cause latent endothelial infection but Dengue virus presents with acute endothelial dysfunction. Influenza and coronaviruses can induce an immediate immune-mediated response, but human herpesvirus type 6, cytomegalovirus and Epstein–Barr virus are found in the majority of the population in latent forms and can reactivate in immunocompromised patients [ 23 , 27 , 28 , 29 ]. Therefore, the need for use of unified terminology has been actualized, distinguishing between virus-mediated and virus-triggered myocarditis and EMB with an adjunct PCR can help to distinguish between them [ 1 ].…”

Section: Resultsmentioning

confidence: 99%

Role of Endomyocardial Biopsy in Diagnostics of Myocarditis

et al. 2022

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Endomyocardial biopsy as the cornerstone of diagnostics has been re-evaluated throughout the years, leaving unanswered questions on the precedence of it. The reported incidence of myocarditis has increased during the pandemic of coronavirus disease 2019 (COVID-19), reinforcing discussions on appropriate diagnostics of myocarditis. By analysis of evidence-based literature published within the last demi-decade, we aimed to summarize the most recent information in order to evaluate the current role of endomyocardial biopsy in diagnostics and management of myocarditis. For the most part, research published over the last five years showed ongoing uncertainty regarding the use, informativeness, safety and necessity of performing a biopsy. Special circumstances, such as fulminant clinical course or failure to respond to empirical treatment, were reconfirmed as justified indications, with a growing applicability of non-invasive diagnostic approaches for most other cases. We concluded that endomyocardial biopsy, if performed properly and with adjunct diagnostic methods, holds a critical role for treatment correction in specific histological subtypes of myocarditis and for differential diagnosis between immune-mediated myocarditis and secondary infections due to immunosuppressive treatment. A high level of possible misdiagnosing was detected, indicating the need to review terminology used to describe findings of myocardial inflammation that did not meet Dallas criteria.

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Section: Resultsmentioning

confidence: 99%

Role of Endomyocardial Biopsy in Diagnostics of Myocarditis

et al. 2022

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“…Only few studies with heterogenous populations have examined dengue and cardiovascular complications, and they applied varying definitions of cardiovascular disease [4]. Moreover, a majority of studies have focused on hospitalized participants with severe dengue [4].…”

Section: Plos Onementioning

confidence: 99%

“…It has been proposed that dengue virus (DENV) can affect individual organ systems, including the cardiovascular system, where it has been associated with myocarditis, electrical abnormalities [4] and left ventricular (LV) impairment [5,6]. While these complications have been observed in the acute phase of the infection, no studies have assessed the long-term effect on the heart following recovery from dengue.…”

Section: Introductionmentioning

confidence: 99%

Potential role of transthoracic echocardiography for screening LV systolic dysfunction in patients with a history of dengue infection. A cross-sectional and cohort study and review of the literature

et al. 2022

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Background Dengue virus can affect the cardiovascular system and men may be at higher risk of severe complications than women. We hypothesized that clinical dengue virus (DENV) infection could induce myocardial alterations of the left ventricle (LV) and that these changes could be detected by transthoracic echocardiography. Methodology/Principal findings We examined individuals from Acre in the Amazon Basin of Brazil in 2020 as part of the Malaria Heart Study. By questionnaires we collected information on self-reported prior dengue infection. All individuals underwent transthoracic echocardiography, analysis of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). We included 521 persons (mean age 40±15 years, 39% men, 50% urban areas) of which 253 (49%) had a history of dengue infection. In multivariable models adjusted for clinical and sociodemographic data, a history of self-reported dengue was significantly associated with lower LVEF (β = -2.37, P < 0.01) and lower GLS (β = 1.08, P < 0.01) in men, whereas no significant associations were found in women (P > 0.05). In line with these findings, men with a history of dengue had higher rates of LV systolic dysfunction (LVEF < 50% = 20%; GLS < 16% = 17%) than those without a history of dengue (LVEF < 50% = 7%; GLS < 16% = 8%; P < 0.01 and 0.06, respectively). Conclusions/Significance The findings of this study suggest that a clinical infection by dengue virus could induce myocardial alterations, mainly in men and in the LV, which could be detected by conventional transthoracic echocardiography. Hence, these results highlight a potential role of echocardiography for screening LV dysfunction in participants with a history of dengue infection. Further larger studies are warranted to validate the findings of this study.

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“…Dengue fever, for example, can occur in a vaccine recipient 2 and cause a heart problem. 3 The VAERS retrospective data may not be able to detect the silent underlying disease or a concomitant medical condition. A history of past infection, for example, cannot rule out previous asymptomatic COVID‐19 infection or another silent concomitant medical issue.…”

Section: Tablementioning

confidence: 99%