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
Meta-Analysis
. 2019 Jun 18;11(6):566.
doi: 10.3390/v11060566.

Systematic Review of PCR Proof of Parvovirus B19 Genomes in Endomyocardial Biopsies of Patients Presenting with Myocarditis or Dilated Cardiomyopathy

Angelos G Rigopoulos  1 , Bianca Klutt  2 , Marios Matiakis  3 , Athanasios Apostolou  4 , Sophie Mavrogeni  5 , Michel Noutsias  6
Affiliations
Meta-Analysis

Systematic Review of PCR Proof of Parvovirus B19 Genomes in Endomyocardial Biopsies of Patients Presenting with Myocarditis or Dilated Cardiomyopathy

Angelos G Rigopoulos et al. Viruses. .

Abstract

Background: Diverse viral infections have been associated with myocarditis (MC) and dilated cardiomyopathy (DCM). In this meta-analysis, we summarize the published results on the association of parvovirus B19 (B19V) genomes with human MC/DCM versus controls.

Methods: n = 197 publications referring to B19V and MC or DCM were retrieved using multiple PubMed search modes. Out of these, n = 29 publications met the inclusion criteria with data from prospective analyses on >10 unselected patients presenting with MC or DCM (dataset: MA01). Data retrieved simultaneously from both controls and MC/DCM patients were available from n = 8 from these publications (dataset: MA02).

Results: In the dataset MA01 B19V genomes were detected in 42.6% of the endomyocardial biopsies (EMB) in this cohort by PCR. In the dataset MA02 comprising n = 638 subjects, there was no statistically significant different rate of B19V positivity in myocardial tissues comparing controls (mean: 38.8 + 24.1%) versus the MC/DCM-patients (45.5 + 24.3%; p = 0.58). There was also no statistical difference between the positivity rate of B19V genomes in myocardial tissues of MA01 (46.0 + 19.5%) and the two patient groups of MA02 (p > 0.05).

Conclusions: This systematic review reveals that the mean rate of PCR detected B19V genomes in patients presenting with MC/DCM does not differ significantly from the findings in control myocardial tissues. These data imply pathogenetically insignificant latency of B19V genomes in a proportion of myocardial tissues, both in MC-/DCM-patients and in controls. More information (i.e., replicative status, viral protein expression) is pertinent to achieve a comprehensive workup of myocardial B19V infection.

Keywords: B19V; diagnosis; dilated cardiomyopathy; erythrovirus; inflammatory cardiomyopathy; myocarditis; parvovirus B19; prognosis.

PubMed Disclaimer

Conflict of interest statement

M.N. has received grants by the Deutsche Forschungsgemeinschaft (DFG) through the Sonderforschungsbereich Transregio 19 “Inflammatory Cardiomyopathy” (SFB TR19) (TP B2), and by the University Hospital Giessen and Marburg Foundation Grant “T cell functionality” (UKGM 10/2009). M.N. has been consultant to the IKDT (Institute for Cardiac Diagnosis and Therapy GmbH, Berlin) 2004–2008.

Figures

Figure 1
Figure 1
Flow chart for the selection of studies. The flow diagram shows the number of studies reviewed and included in the analysis as well as the number of the patients in the different study groups.
Figure 2
Figure 2
Comparing LVEF and LVEDD in the MC/DCM and in the control patients. The numbers on the bars represent the mean value. DCM: dilated cardiomyopathy; LVEF: left ventricular ejection fraction; LVEDD: left ventricular end-diastolic diameter; MC: myocarditis; DCM: dilated cardiomyopathy.
Figure 3
Figure 3
Plot of the n = 8 studies with control group. The mean relative risk (RR) is represented with the grey diamond and the dotted vertical line. The grey squares show the RR for the individual studies, the horizontal lines show the corresponding 95% confidence intervals. Experimental: study group, Control: control group, Events: sum of events, Total: number of patients of the corresponding group, RR: relative risk.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Noutsias M., Maisch B. Myocarditis and pericarditis. In: Tubaro M., Vranckx P., Price S., Vrints C., editors. The ESC Textbook of Acute and Intensive Cardiac Care. 2nd ed. Volume 2. Oxford University Press; Oxford, UK: 2014. pp. 547–560.
    1. D’Ambrosio A., Patti G., Manzoli A., Sinagra G., di Lenarda A., Silvestri F., di Sciascio G. The fate of acute myocarditis between spontaneous improvement and evolution to dilated cardiomyopathy: A review. Heart. 2001;85:499–504. doi: 10.1136/heart.85.5.499. - DOI - PMC - PubMed
    1. Noutsias M., Seeberg B., Schultheiss H.P., Kühl U. Expression of cell adhesion molecules in dilated cardiomyopathy: Evidence for endothelial activation in inflammatory cardiomyopathy. Circulation. 1999;99:2124–2131. doi: 10.1161/01.CIR.99.16.2124. - DOI - PubMed
    1. Angelini A., Calzolari V., Calabrese F., Boffa G.M., Maddalena F., Chioin R., Thiene G. Myocarditis mimicking acute myocardial infarction: Role of endomyocardial biopsy in the differential diagnosis. Heart. 2000;84:245–250. doi: 10.1136/heart.84.3.245. - DOI - PMC - PubMed
    1. Kühl U., Pauschinger M., Seeberg B., Lassner D., Noutsias M., Poller W., Schultheiss H.P. Viral persistence in the myocardium is associated with progressive cardiac dysfunction. Circulation. 2005;112:1965–1970. doi: 10.1161/CIRCULATIONAHA.105.548156. - DOI - PubMed

MeSH terms

LinkOut - more resources