Idiopathic dilated cardiomyopathy and persistent viral infection: Lack of association in a controlled study using a quantitative assay

Moimas, Silvia; Zacchigna, Serena; Merlo, Marco; Buiatti, Alessandra; Anzini, Marco; Dreas, Lorella; Salvi, Alessandro; Lenarda, Andrea Di; Giacca, Mauro; Sinagra, Gianfranco

doi:10.1016/j.hlc.2012.07.013

Cited by 26 publications

(22 citation statements)

References 36 publications

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“…In contrast, more recent studies found a similar prevalence of B19V in control groups [i.e. autopsy, coronary artery bypass grafting or valvular disease patients] compared with MC or DCM patients . This suggests that the mere presence of B19V within the myocardium is insufficient to prove a direct pathophysiological mechanism and indicates that additional factors may be important in a potential aetiological role for B19V, including infection with multiple viruses, viral load, inflammation, active viral replication, exact localization of the infection, and genetic background of the patient.…”

Section: Clinical Studies With Parvovirus B19 In Endomyocardial Biopsiesmentioning

confidence: 87%

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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Section: Clinical Studies With Parvovirus B19 In Endomyocardial Biopsiesmentioning

confidence: 87%

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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“…Since 1993, an additional sample has been systematically frozen in liquid nitrogen and stored at −80°C 8 . The following antigens were tested by using specific antibodies for the identification of myocardial inflammation and for the identification, localization, and characterization of mononuclear cell infiltrates: HLA-DR; CD54 for adhesion molecules; CD4 for helper T cells; CD8 for suppressor T cells; CD25 for regulatory T cells; CD2 for natural killer lymphocytes; CD45RO for memory T cells; and CD68-PGM1 for histiocytes.…”

Section: Emb and Sample Analysismentioning

confidence: 99%

Long-Term Evolution and Prognostic Stratification of Biopsy-Proven Active Myocarditis

et al. 2013

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Background-Active myocarditis is characterized by large heterogeneity of clinical presentation and evolution. This study describes the characteristics and the long-term evolution of a large sample of patients with biopsy-proven active myocarditis, looking for accessible and valid early predictors of long-term prognosis. Methods and Results-From 1981 to 2009, 82 patients with biopsy-proven active myocarditis were consecutively enrolled and followed-up for 147±107 months. All patients underwent clinical and echocardiographic evaluation at baseline and at 6 months. At this time, improvement/normality of left ventricular ejection fraction (LVEF), defined as a LVEF increase > 20 percentage points or presence of LVEF≥50%, was assessed. At baseline, left ventricular dysfunction (LVEF<50%) and left atrium enlargement were independently associated with long-term heart transplantation-free survival, regardless of the clinical pattern of disease onset. At 6 months, improvement/normality of LVEF was observed in 53% of patients. Persistence of New York Heart Association III to IV classes, left atrium enlargement, and improvement/normality of LVEF at 6 months emerged as independent predictors of long-term outcome. Notably, the short-term reevaluation showed a significant incremental prognostic value in comparison with the baseline evaluation (baseline model versus 6 months model: area under the curve 0.79 versus 0.90, P=0.03). Conclusions-Baseline left ventricular function is a marker for prognosis regardless of the clinical pattern of disease onset,and its reassessment at 6 months appears useful for assessing longer-term outcome.

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“…In particular, the definition of a possible role of B19V in the development of chronic cardiomyopathies and cardiac dysfunction is a matter of ongoing debate. Correlation between B19V and cardiomyopathies, in particular dilated cardiomyopathy and ventricular dysfunction, has been proposed by several studies comparing selected groups of patients versus controls [197][198][199][200][201][202][203][204][205], but on the opposite, a lack of significant clinical association has been supported by other groups [206][207][208][209][210][211][212].…”

Section: Cardiomyopathiesmentioning

confidence: 99%

Parvovirus B19 Achievements and Challenges

Gallinella

2013

ISRN Virology

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Parvovirus B19 is a widespread human pathogenic virus, member of the Erythrovirus genus in the Parvoviridae family. Infection can be associated with an ample range of pathologies and clinical manifestations, whose characteristics and outcomes depend on the interplay between the pathogenetic potential of the virus, its adaptation to different cellular environments, and the physiological and immune status of the infected individuals. The scope of this review is the advances in knowledge on the biological characteristics of the virus and of virus-host relationships; in particular, the interactions of the virus with different cellular environments in terms of tropism and ability to achieve a productive replicative cycle, or, on the contrary, to establish persistence; the consequences of infection in terms of interference with the cell physiology; the process of recognition of the virus by the innate or adaptive immune system, hence the role of the immune system in controlling the infection or in the development of clinical manifestations. Linked to these issues is the continuous effort to develop better diagnostic algorithms and methods and the need for development of prophylactic and therapeutic options for B19V infections.

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Idiopathic dilated cardiomyopathy and persistent viral infection: Lack of association in a controlled study using a quantitative assay

Cited by 26 publications

References 36 publications

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

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

Long-Term Evolution and Prognostic Stratification of Biopsy-Proven Active Myocarditis

Parvovirus B19 Achievements and Challenges

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