Fatal parvovirus B19–associated myocarditis clinically mimicking ischemic heart disease: An endothelial cell–mediated disease

Bültmann, B.; Klingel, Karin; Sotlar, Karl; Bock, C.‐Thomas; Baba, Hideo A.; Sauter, Martina; Kandolf, Reinhard

doi:10.1053/hupa.2003.48

Cited by 189 publications

(177 citation statements)

References 15 publications

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“…PVB19 DNA has been found in fetal myocardial cells, in patients with suspected myocarditis, and in patients with cardiac allograft rejection after heart transplantation. 9,19,20 The significance of PVB19 genomes in EMBs of patients with "idiopathic" dilated cardiomyopathy has not yet been clarified, 21,22 but it appears to play a role in the induction of endothelial dysfunction and coronary vasospasms in patients with acute myocarditis mimicking acute myocardial infarction. 6 Endothelial cells have been recognized as targets for PVB19 infection in small cardiac vessels, whereas cardiomyocytes have so far not been described as targets for this virus type.…”

Section: Pvb19 As a Cardiac Pathogenic Agentmentioning

confidence: 99%

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High Prevalence of Cardiac Parvovirus B19 Infection in Patients With Isolated Left Ventricular Diastolic Dysfunction

et al. 2005

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Background-The etiology of left ventricular (LV) isolated diastolic dysfunction often remains unclear. In the present study, we report a strong association between parvovirus B19 (PVB19) genomes and isolated LV diastolic dysfunction. Methods and Results-In 70 patients (meanϮSD age, 43Ϯ11 years) admitted with exertional dyspnea and/or reduced exercise tolerance despite preserved LV systolic contractility (ejection fractionϭ68%), isolated diastolic dysfunction was clinically suspected. Patients with classic risk factors for diastolic dysfunction such as hypertension, coronary heart disease, diabetes mellitus, or pulmonary disease had been excluded. Diastolic function was assessed by echocardiography and LV and RV catheterization. Endomyocardial biopsies (EMBs) were analyzed for the presence of storage or infiltrative diseases or myocarditis, including molecular screening for cardiotropic virus genomes. In a substudy of 24 patients who reported atypical angina, coronary endothelial function was additionally investigated with a coronary Doppler flow-wire technique. In 37 of 70 patients (53%), isolated diastolic dysfunction was confirmed as the cause of their clinical symptoms. No evidence for cardiac storage or infiltrative diseases was found in these cases, but in 35 of 37 of these patients (95%), cardiotropic virus genomes were detected in EMBs (PϽ0.001). PVB19 was the most frequent pathogen in 31 of 37 patients (84%). In a subgroup of 10 patients with diastolic dysfunction and coexisting endothelial dysfunction, all 10 (100%) were PVB19 positive. Conclusions-PVB19 genomes were predominant in patients with unexplained, isolated diastolic dysfunction. A strong association with the incidence of endothelial dysfunction was obvious, consistent with the hypothesis that PVB19-induced endothelial dysfunction may be a possible pathomechanism underlying diastolic dysfunction.

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Section: Pvb19 As a Cardiac Pathogenic Agentmentioning

confidence: 99%

“…9 Detection of parvovirus B19 (PVB19) DNA by nested PCR (nPCR) was performed as described previously with primers specific for the VP1/VP2 coding sequence. 6,9 PVB19-specific primers used for PCR resulted in a PCR amplicon of 290 bp and, in the second round of PCR, in a 173-bp amplicon.…”

Section: Detection Of Viral Genomes In Embs By Npcr and Qpcrmentioning

confidence: 99%

High Prevalence of Cardiac Parvovirus B19 Infection in Patients With Isolated Left Ventricular Diastolic Dysfunction

et al. 2005

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“…Detection of B19V, EV and ADV genomes was performed using nested polymerase chain reaction (PCR) or reverse transcription-polymerase chain reaction (RT-PCR), respectively [Lotze et al, 2004]. Successful isolation of intact viral DNA and total RNA was proved by amplifying the housekeeping gene glyceraldehyde-3-phosphate-dehydrogenase in a nested PCR [Bültmann et al, 2003]. …”

Section: Detection Of Parvoviral Enteroviral and Adenoviral Genomesmentioning

confidence: 99%

“…Differentiation of the three B19V genotypes was performed by identification of the genotypes 1 (prototype), 2 (LaLi-like) and 3 (V9-like) as described previously [Servant et CAT GGG GTT GAG-3). The specificity of the PCR products was as well confirmed by automatic DNA sequencing [Bültmann et al, 2003]. In the virological laboratory in Hannover, the myocardial tissue samples from the control subjects were investigated only quantitatively.…”

Section: Detection Of Parvoviral Enteroviral and Adenoviral Genomesmentioning

confidence: 99%

Low level myocardial parvovirus B19 persistence is a frequent finding in patients with heart disease but unrelated to ongoing myocardial injury

Lotze¹,

Egerer

Glück

et al. 2010

Journal of Medical Virology

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While myocardial parvovirus B19 (B19V), aside from enteroviruses (EV) and adenoviruses (ADV), has recently been found often in patients with myocarditis and idiopathic dilated cardiomyopathy (IDC), the pathogenetic significance of B19V genomes in those patients has not yet been sufficiently elucidated. In the present study, left ventricular endomyocardial biopsies from 24 patients with left ventricular ejection fraction (LVEF) below 55% due to IDC, and tissue from the right atrial appendage of 10 control patients undergoing bypass surgery with normal LVEF (>55%) were investigated for B19V, ADV, and EV genomes by specific nested polymerase chain reaction (PCR), by real time PCR or by reverse‐transcription PCR, respectively. The myocardial tissue samples from the 10 controls were analyzed each in three different virological laboratories for B19V. In the IDC group, the frequency of the myocardial virus genomes found in 54% (13/24) of the patients was as follows: B19V: 50% (12/24), EV: 8% (2/24), including one patient with B19V and EV, and ADV: 0% (0/24). For comparison, the prevalence of B19V genomes was between 30% and 60% in the control group as detected in three different laboratories, but all these control subjects were EV‐ and ADV‐negative. The number of B19V gene copies, however, was very low and similar both in the IDC and control group. In the majority of patients myocardial B19V persistence was associated with a low virus load irrespective of the underlying heart disease so that it may be of no importance in the pathogenesis of IDC. J. Med. Virol. 82:1449–1457, 2010. © 2010 Wiley‐Liss, Inc.

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“…It is a comparatively new observation that the myocardites in DCMs are caused relatively frequently by certain viruses, but appreciably more rarely by others. Following the availability of viral genome detection through virological examinations of myocardial biopsy samples, it has emerged that, of the enteroviruses, Coxsackie B3, human herpes virus 6 (HHV6) and certain adenovirus types are found most often [2][3][4][5][6]; these may be referred to as 'cardiotropic' viruses. In contrast, viral myocarditis is caused more rarely by the Epstein-Barr virus (EBV), cytomegalovirus (CMV) and hepatitis C virus.…”

Section: Introductionmentioning

confidence: 99%

Detection of viral genomes from endomyocardial biopsy samples in dilated cardiomyopathy in hungary

Högye¹,

Csánady²,

Deák³

et al. 2018

Blood Heart Circ

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Background: It is well known that viral myocardites may play a significant role as aetiological factors in the development of dilated cardiomyopathy (DCM). The precise virological diagnosis is very important as it can have therapeutic consequences. The viral incidence reported by the various authors differs in the different geographical regions; we therefore set out to survey the incidence of viruses in a Hungarian DCM population.

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Fatal parvovirus B19–associated myocarditis clinically mimicking ischemic heart disease: An endothelial cell–mediated disease

Cited by 189 publications

References 15 publications

High Prevalence of Cardiac Parvovirus B19 Infection in Patients With Isolated Left Ventricular Diastolic Dysfunction

High Prevalence of Cardiac Parvovirus B19 Infection in Patients With Isolated Left Ventricular Diastolic Dysfunction

Low level myocardial parvovirus B19 persistence is a frequent finding in patients with heart disease but unrelated to ongoing myocardial injury

Detection of viral genomes from endomyocardial biopsy samples in dilated cardiomyopathy in hungary

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