Coxsackievirus B detection in cases of myocarditis, myopericarditis, pericarditis and dilated cardiomyopathy in hospitalized patients

Abstract

Coxsackieviruses B (CV-B) are known as the most common viral cause of human heart infections. The aim of the present study was to assess the potential role of CV-B in the etiology of infectious heart disease in hospitalized patients. The present study is based on blood, pericardial fluid and heart biopsies from 102 patients and 100 control subjects. All of the samples were examined for the detection of specific enteroviral genome using the reverse transcription polymerase chain reaction (RT-PCR) and sequence analysis. Immunohistochemical investigations for the detection of the enteroviral capsid protein, VP1, from the biopsies were performed. The samples were cultured on confluent KB monolayer cell line for possible virus isolation. The epidemiological data were also collected. CV-B was detected in 28 of the 102 patients. The sequence analysis demonstrated that 27 strains were identical to CV-B3 and only one strain was identical to CV-B1. Furthermore, VP1 in the heart biopsies was detected in enterovirus-positive cases, as revealed by RT-PCR. Pericarditis infection was more frequent than myocarditis (P<0.05) or myopericarditis (P=0.05). The epidemiological data demonstrate that CV-B heart infections occur mainly during autumn and winter, and young male adults are more susceptible than adolescents or adults (P<0.5). The present findings demonstrate a higher prevalence of viral heart infections, suggesting that CV-B may significantly contribute to heart infections.

Non-polio enteroviruses among healthy children in the Philippines

“…The isolation of CV-B1 in all sites is consistent with a previous study where Coxsackievirus B (CVB) was classified as one of the EV serotypes with endemic circulation in the Philippines [15]. This EV species has been known to be the most common viral cause of human heart infections [16]. There was also an isolation of CV-B4 from a child enrolled in the study and this subtype is known to be an environmental risk factor in the non-genetic causes of type 1 diabetes mellitus [17].…”

Seasonal patterns of acute and recurrent idiopathic pericarditis

“…The diagnosis of acute pericarditis was based, as recommended by current guidelines, on the presence of at least 2 of the following 4 criteria: typical pleuritic chest pain, characteristic electrocardiographic changes, pericardial friction rub, and new or worsening pericardial effusion . The criteria for the diagnosis of a recurrent episode of pericarditis included a documented first attack of acute pericarditis, a symptom‐free interval of 6 weeks or longer, patient complaints of recurrent pain, and 1 or more of the following signs: pericardial friction rub, electrocardiographic changes suggestive of pericarditis, imaging evidence of new or worsening pericardial effusion, and an elevation in C‐reactive protein level or erythrocyte sedimentation rate …”

“…4 The criteria for the diagnosis of a recurrent episode of pericarditis included a documented first attack of acute pericarditis, a symptom-free interval of 6 weeks or longer, patient complaints of recurrent pain, and 1 or more of the following signs: pericardial friction rub, electrocardiographic changes suggestive of pericarditis, imaging evidence of new or worsening pericardial effusion, and an elevation in C-reactive protein level or erythrocyte sedimentation rate. 6,7,9,10 Peak values of plasma C-reactive protein level and body temperature were recorded in all cases; white blood cell count was recorded at admission. An elevated plasma troponin level was defined according to the criteria used at the time of measurement.…”

“…For example, although epidemics of influenza occur almost exclusively during winter in temperate climate zones, the virus has year‐round activity in the tropics . Epstein–Barr virus infections are more common in winter than summer, whereas coxsackievirus B heart infections occur mainly during autumn and winter and other enterovirus infections peak in September to November . Attacks of enteroviral pericarditis follow seasonal epidemics of coxsackievirus A + B and echovirus infections…”

Structure–activity relationship of N-benzenesulfonyl matrinic acid derivatives as a novel class of coxsackievirus B3 inhibitors

“…Especially, group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing pleurodynia, myocarditis, pericarditis, and hepatitis (inflammation of the liver not related to the hepatotropic viruses). 3,4 Up to now, at least 6 serotypes of coxsackieviruses group B (CVB 1-6) viruses have been recognized. Among them, coxsackieviruses B3 (CVB3) are considered as the leading causes of human myocarditis and dilated cardiomyopathy.…”