Epstein-Barr futile myocarditis requiring urgent orthotopic heart transplantation

Antonakaki, Dimitra; Mirza, Sajjad Ahmed; Sundar, Shweta Kalyana; Grapsa, Julia

doi:10.1177/0267659115618460

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…However, a chronic active Epstein-Barr virus (CAEBV) infection characterized by high EBV DNA levels in the peripheral blood (Kawabe et al, 2018) can cause organ damage demonstrated by endomyocardial biopsies with lymphocytic infiltration, necrosis of cardiomyocytes et cetera and end up in a chronic active myocarditis (Takano et al, 2008). Sometimes, an Epstein-Barr myocarditis (Antonakaki et al, 2016) is so severe that an urgent orthotopic heart transplantation is necessary. Finally, Aghenta et al (Aghenta et al, 2008) published the case of a 19-year-old healthy male patient presented to hospital with clinical features of infectious mononucleosis (IM).…”

Section: Discussionmentioning

confidence: 99%

Epstein Barr Virus and Atrial Fibrillation

Barukčić¹

2019

MHS

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Objective: Atrial fibrillation (AF) is very frequent and clinically significant arrhythmia. The incidence of atrial fibrillation is continuously rising. Meanwhile several risk factors for AF development have been identified but the etiology is not cleared. Methods: A systematic review and re-analysis of studies which investigated the relationship between AF and some risk factors was conducted. The method of the conditio sine qua non relationship, the method of the conditio per quam relationship, the method of the exclusion relationship and the mathematical formula of the causal relationship k were used to proof the hypothesis. Significance was indicated by a p-value of less than 0.05. Results: The studies analyzed were able to provide direct and indirect evidence that AF is caused by a process of inflammation while a direct identification of the factor causing AF was not possible. Still, it appears to be very probable that Epstein-Barr virus (EBV) is the cause of AF. Conclusion: Atrial fibrillation (AF) appears to be caused by an EBV inflammatory process.

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Section: Discussionmentioning

confidence: 99%

Epstein Barr Virus and Atrial Fibrillation

Barukčić¹

2019

MHS

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“…This immune-mediated damage may be led by CD8 + T cells [81]. Reported cases, although rare, have generally been severe, even requiring heart transplantation, although this may reflect an underreporting of the subclinical presence of EBV in the heart [150]. Electron microscopy studies have revealed the presence of EBV antigens in cardiomyocytes and intramural vessels of patients with myocarditis and DCMi, despite the virus' general tropism for B lymphocytes [82,83].…”

Section: Herpesviridaementioning

confidence: 99%

Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches

Baumeier

Harms

Aleshcheva

et al. 2023

JCM

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The diagnosis and specific and causal treatment of myocarditis and inflammatory cardiomyopathy remain a major clinical challenge. Despite the rapid development of new imaging techniques, endomyocardial biopsies remain the gold standard for accurate diagnosis of inflammatory myocardial disease. With the introduction and continued development of immunohistochemical inflammation diagnostics in combination with viral nucleic acid testing, myocarditis diagnostics have improved significantly since their introduction. Together with new technologies such as miRNA and gene expression profiling, quantification of specific immune cell markers, and determination of viral activity, diagnostic accuracy and patient prognosis will continue to improve in the future. In this review, we summarize the current knowledge on the pathogenesis and diagnosis of myocarditis and inflammatory cardiomyopathies and highlight future perspectives for more in-depth and specialized biopsy diagnostics and precision, personalized medicine approaches.

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“…An acute case of EBV-induced heart inflammation has been previously associated with the presence of lymphocytic infiltrates and a T cell marker CD 45 R0 ( Ishikawa et al, 2005 ). The disease severity progression and the outcome vary among patients, and in some cases symptoms can resolve on their own, whereas in others the heart becomes irreversibly damaged, resulting in a patient’s death ( Ishikawa et al, 2005 ; Antonakaki et al, 2016 ). Reactivation of the virus after the initial infection has also been previously reported, as shown by the presence of EBV-encoded RNA and mononuclear infiltrates in the pericardium ( Richter et al, 2013 ).…”

Section: Herpesvirusesmentioning

confidence: 99%

Persistent viral infections and their role in heart disease

2022

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Viral infections are the culprit of many diseases, including inflammation of the heart muscle, known as myocarditis. Acute myocarditis cases have been described in scientific literature, and viruses, such as parvovirus B19, coxsackievirus B3, or more recently, SARS-CoV-2, were the direct cause of cardiac inflammation. If not treated, myocarditis could progress to dilated cardiomyopathy, which permanently impairs the heart and limits a person’s lifespan. Accumulated evidence suggests that certain viruses may persist in cardiac tissue after the initial infection, which could open up the door to reactivation under favorable conditions. Whether this chronic infection contributes to, or initiates, cardiac damage over time, remains a pressing issue in the field of virus-induced heart pathology, and it is directly tied to patients’ treatment. Previously, large case studies found that a few viruses: parvovirus B19, coxsackievirus, adenovirus, human herpesvirus 6, cytomegalovirus and Epstein–Barr virus, are most commonly found in human endomyocardial biopsy samples derived from patients experiencing cardiac inflammation, or dilated cardiomyopathy. SARS-CoV-2 infection has also been shown to have cardiovascular consequences. This review examines the role of viral persistence in cardiac inflammation and heart disease, and discusses its implications for patients’ outcomes.

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Epstein-Barr futile myocarditis requiring urgent orthotopic heart transplantation

Cited by 3 publications

References 5 publications

Epstein Barr Virus and Atrial Fibrillation

Epstein Barr Virus and Atrial Fibrillation

Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches

Persistent viral infections and their role in heart disease

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