Frequency and quantity of the
parvovirus B19 genome in endomyocardial biopsies from patients
with suspected myocarditis or idiopathic left ventricular
dysfunction

Klein, Rolf Michael; Jiang, Hong; Niederacher, Dieter; Adams, Ortwin; Du, Miaomiao; Horlitz, M; Schley, Philipp; Marx, R.; Lankisch, Mark; Brehm, Michael; Strauer, B. E.; Gabbert, Helmut E.; Scheffold, Thomas; Gülker, H

doi:10.1007/s00392-004-0079-z

Cited by 38 publications

(2 citation statements)

References 33 publications

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“…Throughout the last 50–60 years, temporal fluctuations in the prevalence of different viruses associated with myocarditis have been documented [ 14 ]. In the last decades, Parvovirus B19 (PVB19) has become the more prominent virus amplified in EMBs of patients with myocarditis and DCM [ 15 ], both in adults [ 16 , 17 , 18 ] and children [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Specific Viruses on Clinical Outcome in Children Presenting with Acute Heart Failure

Gagliardi

Fierabracci

Pilati

et al. 2016

IJMS

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The presence and type of viral genomes have been suggested as the main etiology for inflammatory dilated cardiomyopathy. Information on the clinical implication of this finding in a large population of children is lacking. We evaluated the prevalence, type, and clinical impact of specific viral genomes in endomyocardial biopsies (EMB) collected between 2001 and 2013 among 63 children admitted to our hospital for acute heart failure (median age 2.8 years). Viral genome was searched by polymerase chain reaction (PCR). Patients underwent a complete two-dimensional echocardiographic examination at hospital admission and at discharge and were followed-up for 10 years. Twenty-seven adverse events (7 deaths and 20 cardiac transplantations) occurred during the follow-up. Viral genome was amplified in 19/63 biopsies (35%); PVB19 was the most commonly isolated virus. Presence of specific viral genome was associated with a significant recovery in ejection fraction, compared to patients without viral evidence (p < 0.05). In Cox-regression analysis, higher survival rate was related to virus-positive biopsies (p < 0.05). When comparing long-term prognosis among different viral groups, a trend towards better prognosis was observed in the presence of isolated Parvovirus B19 (PVB19) (p = 0.07). In our series, presence of a virus-positive EMB (mainly PVB19) was associated with improvement over time in cardiac function and better long-term prognosis.

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Section: Introductionmentioning

confidence: 99%

The Impact of Specific Viruses on Clinical Outcome in Children Presenting with Acute Heart Failure

Gagliardi

Fierabracci

Pilati

et al. 2016

IJMS

View full text Add to dashboard Cite

show abstract

“…(7,8,20) In a proportion of patients, there is an absence of PVB19-specific T cells, which results in inadequate viral clearance and persistence of PVB19 in the myocardium, leading to chronic myocardial inflammation. (40)(41)(42) Even in patients with complete viral clearance, ongoing myocardial inflammation can result from an autoimmune response against host myocardial antigens induced by molecular mimicry. (43) The resultant chronic myocarditis secondary to either viral persistence or autoimmunity can lead to dilated cardiomyopathy.…”

Section: Case Discussionmentioning

confidence: 99%

Unpacking the mysteries of Parvovirus B19 Myocarditis

Hassan¹,

Doubell²,

Herbst³

2022

SAHJ

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Myocarditis is an inflammatory disease of the heart muscle, most often caused by viral infections. Its diagnosis can be difficult due to the heterogeneity of presentations that often mimic other common cardiological conditions, such as acute coronary syndrome (ACS) and heart failure. Although most cases are benign and self-limiting, it can also take on a more malignant course complicated by life-threatening arrhythmias, cardiogenic shock, and sudden cardiac death (SCD). A certain proportion of patients progress to develop dilated cardiomyopathies (DCMO). The developed world has experienced a shift in viral pathogens detected in patients with acute myocarditis over the past 20 years, and Parvovirus B19 (PVB19) and human herpesvirus-6 (HHV6) are currently the most commonly identified viruses in the myocardium of patients with viral myocarditis. The clinical relevance and pathological roles of these viruses however remain questioned. This focused review aims to use 2 cases of PVB19 myocarditis managed by our unit to explore issues related to the clinical presentation, diagnosis, treatment and prognosis of PVB19 myocarditis along with controversies surrounding the pathogenic role and clinical relevance of PVB19 in myocarditis.

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Parvovirus B19 infection during pregnancy and risks to the fetus

Ornoy¹,

Ergaz

2017

Birth Defects Research

106

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Parvovirus B19 infects 1 to 5% of pregnant women, generally with normal pregnancy outcomes. During epidemics, the rate of infection is higher. Major congenital anomalies among offspring of infected mothers are rare, as the virus does not appear to be a significant teratogen. However, parvovirus B19 infection may cause significant fetal damage, and in rare cases, brain anomalies and neurodevelopmental insults, especially if infection occurs in the first 20 weeks of pregnancy. Parvovirus B19 is also an important cause of fetal loss, especially in the second half of pregnancy when spontaneous fetal loss from other causes is relatively rare. Parvovirus B19 infection may affect many fetal organs and can cause severe anemia, following fetal erythroid progenitor cells infection and apoptosis, especially in fetuses, that have shortened half-life of erythrocytes. Severe anemia may cause high output cardiac failure and nonimmune hydrops fetalis. In addition, parvovirus B19 may directly infect myocardial cells and produce myocarditis that further aggravates the cardiac failure. Intrauterine fetal transfusion is commonly used for the treatment of severe fetal anemia with survival rates of 75 to 90% and significant reduction of fetal morbidity. Only 66 cases were evaluated neurodevelopmentally, of which 10 (16%) had slight or severe neurodevelopmental problems. Because parvovirus B19 infection can cause severe fetal morbidity and mortality, it should be part of the routine work-up of pregnant women who have been exposed to the virus or of pregnancies with suspected fetal hydrops. Assessment for maternal infection during pregnancy is especially important during epidemics, when sero-conversion rates are high. Birth Defects Research 109:311-323, 2017. © 2017 Wiley Periodicals, Inc.

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Frequency and quantity of the parvovirus B19 genome in endomyocardial biopsies from patients with suspected myocarditis or idiopathic left ventricular dysfunction

Cited by 38 publications

References 33 publications

The Impact of Specific Viruses on Clinical Outcome in Children Presenting with Acute Heart Failure

The Impact of Specific Viruses on Clinical Outcome in Children Presenting with Acute Heart Failure

Unpacking the mysteries of Parvovirus B19 Myocarditis

Parvovirus B19 infection during pregnancy and risks to the fetus

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