Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct;14(6):1245-1253.
doi: 10.5114/aoms.2018.79002. Epub 2018 Oct 23.

Viral genome changes and the impact of viral genome persistence in myocardium of patients with inflammatory cardiomyopathy

Dalibor Mlejnek  1 , Jan Krejci  1 , Petr Hude  1 , Eva Ozabalova  1 , Vita Zampachova  1 , Radka Stepanova  2 , Iva Svobodová  1 , Tomas Freiberger  3 , Eva Nemcova  3 , Lenka Spinarova  1
Affiliations

Viral genome changes and the impact of viral genome persistence in myocardium of patients with inflammatory cardiomyopathy

Dalibor Mlejnek et al. Arch Med Sci. 2018 Oct.

Abstract

Introduction: Viral infections are considered the most frequent cause of myocarditis and dilated cardiomyopathy (DCM).

Material and methods: We investigated the changes in viral presence and the impact of viral genome persistence in the myocardium on echocardiographic parameters, functional status and some laboratory parameters in a 6-month follow-up. Fifty-four patients with recent onset DCM, left ventricular ejection fraction < 40% and biopsy-proven myocarditis (> 14 mononuclear leukocytes/mm2 and/or > 7 T-lymphocytes/mm2) were enrolled. Polymerase chain reaction (PCR) was performed to detect pathogens in the myocardium. Patients were divided according to the administered therapy: standard heart failure medication (46 patients) and immunosuppressive therapy (8 patients).

Results: In the standard heart failure medication group viral clearance was observed in 13 patients and viral persistence in 24 patients in the follow-up period. Comparing both groups, there was no statistically significant difference - LVEF improvement of 12.0 ±11.4% vs. 18.3 ±12.6%, decrease in NYHA class of 0.7 ±0.7 vs. 1.0 ±0.7, decline in NT-proBNP of 1335 ±1933 ng/l vs. 1942 ±3242 ng/l and decrease in infiltrating leukocytes of 11.1 ±15.8 vs. 6.7 ±23.0 cells/mm2 and T-lymphocytes of 5.8 ±15.1 vs. 1.8 ±10.9 cells/mm2 (all p = NS). A decrease in PCR positive patients from 37 to 29 was observed. The number of PVB19 positive PCR findings decreased from 5 to 4 in patients with immunosuppressive therapy.

Conclusions: A decrease in the number of positive PCR findings in control endomyocardial biopsy was observed. Viral genome persistence was not associated with worse outcome in short-term follow-up.

Keywords: dilated cardiomyopathy; endomyocardial biopsy; inflammatory cardiomyopathy; myocarditis; polymerase chain reaction.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Viral genome distribution at baseline (A) and after 6 months (B) – standard heart failure therapy only
Figure 2
Figure 2
Viral genome distribution at baseline (A) and after 6 months (B) – immunosuppressive therapy added to standard heart failure therapy
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kusiak A, Wiliński J, Wojciechowska W, et al. Echocardiographic assessment of right ventricular function in responders and non-responders to cardiac resynchronization therapy. Arch Med Sci. 2015;11:736–42. - PMC - PubMed
    1. Stehlik J, Edwards LB, Kucheryavaya AY, et al. The Registry of the International Society for Heart and Lung Transplantation: twenty-seventh official adult heart transplant report--2010. J Heart Lung Transplant. 2010;29:1089–103. - PubMed
    1. Cooper LT. The heat is off: immunosuppression for myocarditis revisited. Eur Heart J. 2009;30:1936–9. - PubMed
    1. Krejci J, Poloczkova H, Hude P, et al. Impact of inflammatory infiltration and viral genome presence in myocardium on the changes of echocardiographic parameters. Cor et Vasa. 2013;4:e333–40.
    1. Kühl U, Pauschinger M, Noutsias M, et al. High prevalence of viral genomes and multiple viral infections in the myocardium of adults with “idiopathic” left ventricular dysfunction. Circulation. 2005;111:887–93. - PubMed