Recent-onset dilated cardiomyopathy associated with Borrelia burgdorferi infection

Kuchynka, Petr; Paleček, Tomáš; Havránek, Štěpán; Vítková, Ivana; Nemecek, Eduard; Trckova, Radka; Berenová, Dagmar; Krsek, Daniel; Podzimkova, Jana; Fikrle, Michal; Danek, Barbara A.; Linhart, Aleš

doi:10.1007/s00059-015-4308-1

Cited by 17 publications

(15 citation statements)

References 18 publications

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“…Furthermore, in our very recently published study, the Bb genome was detected in 22 (20%) out of 110 patients with recent-onset unexplained DCM (ref. 7 ). All Bb-positive patients were treated with intravenous ceftriaxone for 21 days in addition to conventional heart failure medication and showed significant improvement of LV ejection fraction and heart failure symptoms at one-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Within the endemic region of Central Europe there is increasing evidence that Borrelia burgdorferi (Bb) may be associated with the development of DCM (ref. [5][6][7] ). To further support a causal relationship between the presence of Bb in the heart muscle and the development of DCM, demonstration of the absence of Bb in the myocardium of subjects with normal left ventricular (LV) systolic function is necessary.…”

Section: Introductionmentioning

confidence: 99%

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Absence of Borrelia burgdorferi in the myocardium of subjects with normal left ventricular systolic function: a study using PCR and electron microscopy

Kuchynka¹,

Paleček²,

Grus³

et al. 2016

BIOMED PAP

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, Ales Linhart aBackground. Several studies have demonstrated the presence of the Borrelia burgdorferi (Bb) genome in the myocardium of patients with dilated cardiomyopathy (DCM). To further support a causal relationship between the presence of Bb in the heart muscle and the development of DCM, demonstration of the absence of Bb in the myocardium of subjects with normal left ventricular (LV) systolic function is needed. Aim. To determine the prevalence of Bb by polymerase chain reaction (PCR) and electron microscopy (EM) in individuals with normal LV systolic function and no history suggestive of myocarditis. Methods. We investigated 50 patients (67 ± 9 years, 15 women) with normal LV ejection fraction (EF) ≥ 50% undergoing cardiac surgery. During surgery, four samples from the right atrial appendage were obtained and subsequently examined by PCR and EM for the presence of Bb, and by immunohistochemistry to detect inflammatory cells. Serological testing of antibodies against Bb was also performed. Results. Neither PCR nor EM detected

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Absence of Borrelia burgdorferi in the myocardium of subjects with normal left ventricular systolic function: a study using PCR and electron microscopy

Kuchynka¹,

Paleček²,

Grus³

et al. 2016

BIOMED PAP

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“…Symptoms of Lyme borreliosis can vary widely among patients and may include characteristic skin lesions, arthritis, meningitis, radiculoneuritis, facial nerve paralysis, ocular involvement and atrioventricular nodal block [10,[15][16][17][18][19][20]. Notably, symptoms caused by some relapsing fever species, e.g.…”

Section: Risks To Human Health and Patient Safetymentioning

confidence: 99%

Rejection of the name Borreliella and all proposed species comb. nov. placed therein

Margos

Castillo-Ramírez

Cutler

et al. 2020

International Journal of Systematic and Evolutionary Microbiology

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Rejection (nomen rejiciendum) of the name Borreliella and all new combinations therein is being requested on grounds of risk to human health and patient safety (Principle 1, subprinciple 2 and Rule 56a) and violation to aim for stability of names, to avoid useless creation of names (Principle 1, subprinciple 1 and 3) and that names should not be changed without sufficient reason (Principle 9 of the International Code of Nomenclature of Prokaryotes).

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“…Serological diagnosis in patients with cardiac LD may be difficult, as IgM and IgG antibodies against B. burgdorferi are frequently negative at first; a measurable level of antibodies develops in the course of illness [75,78]. Therefore, EMB can be extremely useful in making the diagnosis of DCM caused by B. burgdorferi [79]. Early treatment with antibiotic therapy (intravenous infusion of ceftriaxone) is effective and leads to significant improvement of left ventricle ejection fraction and reduction of heart failure symptoms [75,79].…”

Section: Borrelia Burgdorferimentioning

confidence: 99%

“…Therefore, EMB can be extremely useful in making the diagnosis of DCM caused by B. burgdorferi [79]. Early treatment with antibiotic therapy (intravenous infusion of ceftriaxone) is effective and leads to significant improvement of left ventricle ejection fraction and reduction of heart failure symptoms [75,79].…”

Section: Borrelia Burgdorferimentioning

confidence: 99%

Infective Cardiomyopathy

Pawlak¹,

Gil²

2017

Cardiomyopathies - Types and Treatments

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Both the infectious agent and development of inflammatory response to infection can lead to irreversible myocardial injury, which affects the outcome of short-and long-term prognosis. In the case of the rapid elimination of the infectious agent and rapid withholding of inflammatory process, changes in myocardium are small. If the immune response does not lead to complete elimination of infectious agent or inflammation progresses after removing the virus, chronic myocardial damage may develop. Persistence of the virus in myocardium, postinfectious immune reaction, autoimmunity, and primary cardiac damage may result in the development of progressive ventricular dysfunction, development of cardiac arrhythmias, and exacerbation of symptom. Because of the long-term consequences, it is important to diagnose infective cardiomyopathy (IC) quickly and start appropriate treatment. However, IC is still a diagnostic challenge. Infective cardiomyopathy is often underdiagnosed because of a wide spectrum of factors causing IC-infectious, toxic, immunologic, and various clinical manifestation. The processes responsible for the development of IC take place at the cellular level, which is why it is important to make the diagnosis not only based on clinical symptoms and imaging but also to confirm it with the use of histological, immunohistochemical, and molecular studies. Progress in the diagnosis and understanding of the pathomechanisms responsible for the development of IC contributed to the use of new therapeutic options. Immunosuppresive and immunomodulative treatment is still of limited use. However, in some cases of viral IC, targeted antiviral treatment can be added to the standard heart failure therapy resulting in improvement of the prognosis.Infective cardiomyopathy may be caused by many etiological factors including viruses, bacteria, rickettsiae, fungi, protozoa, and parasites. However, the spectrum of pathogens has changed over the decades and also varies geographically as, for example, Trypanosoma cruzi [4]. Moreover, it can result from noninfectious agents, such as allergic agents, autoimmunity, toxins, and drugs [5]. Etiological factors that could cause IC are presented in Table 1. The most popular infective agents VirusesRNA viruses:

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Recent-onset dilated cardiomyopathy associated with Borrelia burgdorferi infection

Abstract: Targeted antibiotic treatment of Bb-related recent-onset DCM in addition to conventional heart failure therapy is associated with favorable cardiac remodeling and improvement of heart failure symptoms.

Cited by 17 publications

References 18 publications

Absence of Borrelia burgdorferi in the myocardium of subjects with normal left ventricular systolic function: a study using PCR and electron microscopy

Absence of Borrelia burgdorferi in the myocardium of subjects with normal left ventricular systolic function: a study using PCR and electron microscopy

Rejection of the name Borreliella and all proposed species comb. nov. placed therein

Infective Cardiomyopathy

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