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

Gagliardi, Maria Giulia; Fierabracci, Alessandra; Pilati, Mara; Chinali, Marcello; Bassano, Carlo; Saura, Francesca; Giovannoni, Isabella; Francalanci, Paola

doi:10.3390/ijms17040486

Cited by 16 publications

(11 citation statements)

References 32 publications

(32 reference statements)

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“…Prognostic studies of the presence of B19V in EMB in children are contradictory and scarce ( Table ). A recent study showed a better outcome for children with a virus‐positive EMB (mainly B19V) . In accord with these results, viral presence had no influence on outcome in another study .…”

Section: Parvovirus B19‐related Heart Disease In Childrensupporting

confidence: 52%

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

126

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: Parvovirus B19‐related Heart Disease In Childrensupporting

confidence: 52%

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

126

121

View full text Add to dashboard Cite

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“…72–74 Parvovirus B19, influenza, Epstein-Barr, HIV, coxsackie virus, herpes, and adenovirus have all been identified. 73–77 Murine models of myocarditis (coxsackie or adenoviral) demonstrate evidence of disruption of several important pathways in the innate and activated immune systems. 78, 79 The enteroviral protease 2A has been demonstrated to cleave the cytoskeletal protein- dystrophin which results in severe DCM.…”

Section: Dilated Cardiomyopathymentioning

confidence: 99%

“…Potential targets for investigation include genetic variants, circulating or imaging markers of inflammation or stress, neurohormonal abnormalities, microRNA, viral genome on endomyocardial biopsy, and markers of extracardiac impairment. 51, 73, 74, 94, 101, 102, 108, 109 Identifying biomarkers that are important for pediatric patients is the focus of a large ongoing study by the PCMR and is an area of research need.…”

Section: Dilated Cardiomyopathymentioning

confidence: 99%

Pediatric Cardiomyopathies

Lee

Hsu

Kantor

et al. 2017

Circulation Research

240

218

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Pediatric cardiomyopathies are rare diseases with an annual incidence of 1.1–1.5 per 100,000. Dilated and hypertrophic cardiomyopathies are the most common; restrictive, noncompaction, and mixed cardiomyopathies occur infrequently; and arrhythmogenic right ventricular cardiomyopathy is rare. Pediatric cardiomyopathies can result from coronary artery abnormalities, tachyarrhythmias, exposure to infection or toxins, or secondary to other underlying disorders. Increasingly, the importance of genetic mutations in the pathogenesis of isolated or syndromic pediatric cardiomyopathies is becoming apparent. Pediatric cardiomyopathies often occur in the absence of co-morbidities such as atherosclerosis, hypertension, renal dysfunction, and diabetes; as a result, they offer insights into the primary pathogenesis of myocardial dysfunction. Large international registries have characterized the epidemiology, etiology, and outcomes of pediatric cardiomyopathies. Although adult and pediatric cardiomyopathies have similar morphologic and clinical manifestations, their outcomes differ significantly. Within two years of presentation, normalization of function occurs in 20% of children with dilated cardiomyopathy, and 40% die or undergo transplantation. Infants with hypertrophic cardiomyopathy have a two-year mortality of 30%, whereas death is rare in older children. Sudden death is rare. Molecular evidence indicates that gene expression differs between adult and pediatric cardiomyopathies, suggesting treatment response may differ as well. Clinical trials to support evidence-based treatments and the development of disease-specific therapies for pediatric cardiomyopathies are in their infancy. This compendium summarizes current knowledge of the genetic and molecular origins, clinical course, and outcomes of the most common phenotypic presentations of pediatric cardiomyopathies, and highlights key areas where additional research is required.

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“…19 Parvovirus B19 and Epstein-Barr virus are most frequently isolated by cardiac biopsy in children. 86,87 About one fourth of children with DCM have underlying neuromuscular disorders, specifically Duchenne and Becker muscular dystrophies. 88 Overall, DCM seems to have a worse prognosis in children than in adults.…”

Section: Pediatric Cardiomyopathiesmentioning

confidence: 99%

“…86,87 Our understanding of this cardiomyopathy is still relatively primitive. It is not clear how often it represents a congenital disorder based on an embryological defect in children.…”

Section: Pediatric Cardiomyopathiesmentioning

confidence: 99%