Link between enteroviruses and dilated cardiomyopathy: serological and molecular data

Keeling, PJ; Tracy, Steven

doi:10.1136/hrt.72.6_suppl.s25

Cited by 25 publications

(11 citation statements)

References 39 publications

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“…Although that rate is exceedingly high compared to the control group and also to the previously published data concerning noninflammatory myocardium [16,41], we have to keep in mind that the control samples were obtained of patients that did not come from geographical areas where EMF occurs. Both experimental and human studies have already detected viral persistence in several chronic heart diseases, such as endocardial fibroelastosis and idiopathic dilated cardiomyopathy [42,43]. The persistence of this so-called defective virus is often associated with slight cytolysis and consequently with mild inflammatory infiltrate.…”

Section: Discussionmentioning

confidence: 99%

Endomyocardial fibrosis: pathological and molecular findings of surgically resected ventricular endomyocardium

et al. 2008

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Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown etiology prevalent in tropical regions affecting the inflow tract and apex of one or both ventricles, which show fibrous thickening of the endocardium and adjacent myocardium. Surgical treatment is recommended for patients in functional classes III or IV (New York Heart Association). The gross and histological features of the heart have been comprehensively studied in autopsies, but studies in surgical samples are still lacking. Histological and immunohistochemical features of EMF in surgical samples collected from 32 patients were described and correlated with clinical data. Polymerase chain reaction (PCR) and reverse transcription-PCR, performed on formalin fixed endomyocardial samples, were used retrospectively to detect genomes of certain cardiotropic viruses and Toxoplasma gondii. Ventricular endocardium was thickened by superficial acellular hyaline collagen fibers type I and III, with predominance of the former type. Besides fibrosis, a chronic inflammatory process and an anomalous lymphatic rich vascular pattern were observed in the deep endocardium, connected to the terminal coronary circulation of the myocardium, which might be an important pathological finding concerning EMF pathogenesis. Molecular analysis of the endomyocardium revealed high incidence of cardiotropic infective agents (6/12, 50%); however, their role in the disease pathogenesis is still controversial.

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Section: Discussionmentioning

confidence: 99%

Endomyocardial fibrosis: pathological and molecular findings of surgically resected ventricular endomyocardium

et al. 2008

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“…Coxsackie B-specific immunoglobulin M is identified in patients with recent diagnosis and end-stage forms 10,11 . Although this immunoglobulin is found more frequently in the DCM group than in nonselected controls 10 , no difference is seen when serologic data are compared with that obtained from relatives sharing the same domicile 12 . Sequential evaluation of serum specimens revealed antibodies persisting in some cases, as well as late seroconversion after reactions become negative in other cases 11,12 .…”

Section: Role Of Viral Infectionmentioning

confidence: 94%

“…The presence of enteroviral genomes combined with the persistence of serologic reactions suggests the possibility of the virus remaining in the myocardium after the acute phase, with no evidence of protein synthesis but nonetheless interference with cellular functions 12 . This hypothesis becomes questionable because the enteroviral RNA proportion usually detected through PCR in these hearts is small and localized 19 .…”

Section: Role Of Viral Infectionmentioning

confidence: 99%

“…As this process evolves, activation of cytotoxic T lymphocytes occurs, which intensifies the injury of infected and intact cells during lysis 22 . Persistence of infection could result in exacerbation of the cellular and humoral immunologic response, which would perpetuate aggression against myocytes 12 . Autoimmune reaction would result from molecular mimesis between viral and host proteins or from neoantigen expression 23 .…”

Section: Activation Of Immunologic Mechanismsmentioning

confidence: 99%

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Cellular and biomolecular mechanisms in dilated cardiomyopathy

Mattos¹

1999

Arq. Bras. Cardiol.

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“…A genetic susceptibility to mount a reaction to myocardial infection or toxicity would explain a dominant inheritance in some families (fig 4). 18 19 20…”

Section: Dilated Cardiomyopathymentioning

confidence: 99%

Aetiology, diagnosis, investigation, and management of the cardiomyopathies

Oakley

1997

BMJ

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Link between enteroviruses and dilated cardiomyopathy: serological and molecular data

Cited by 25 publications

References 39 publications

Endomyocardial fibrosis: pathological and molecular findings of surgically resected ventricular endomyocardium

Endomyocardial fibrosis: pathological and molecular findings of surgically resected ventricular endomyocardium

Cellular and biomolecular mechanisms in dilated cardiomyopathy

Aetiology, diagnosis, investigation, and management of the cardiomyopathies

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