Adenoviruses and enteroviruses as pathogens in myocarditis and dilated cardiomyopathy.
BACKGROUND
Enteroviruses were detected in up to 50% in myocardium of patients with myocarditis and dilated cardiomyopathy, the latter being considered as a result of a prior subclinical myocarditis. A wide range of other infectious agents are being discussed as pathogens, often only based on reports of single cases. Adenovirus genome was recently identified in a significant number in the myocardium of paediatric patients with myocarditis. However, data on the role of adenoviruses for the aetiopathogenesis of myocarditis in adult patients is missing so far. Therefore, we studied the prevalence of adenoviral and enteroviral genome in myocardium of adults with myocarditis and dilated cardiomyopathy.


METHODS
15 patients were diagnosed at baseline with myocarditis, 16 patients with dilated cardiomyopathy according to clinical and histological criteria. Endomyocardial biopsies of these patients and 8 control patients with non-infectious heart diseases were evaluated by polymerase chain reactions for enterovirus and adenovirus genome.


RESULTS
Enteroviral genome was detected in 27.3% patients with myocarditis or dilated cardiomyopathy, whereas adenoviral genome was not identified in any patient. Samples from control subjects systematically yielded negative results.


CONCLUSIONS
From our data, it seems doubtful that adenoviruses are major pathogens of myocarditis or DCM, whereas enterovirus genome was identified in a significant number of patients with both diseases.
Grumbach
I M
IM
Department of Internal Medicine, Georg-August-Universität, Göttingen, Germany. imgrum@uic.edu
Heim
A
A
Pring-Akerblom
P
P
Vonhof
S
S
Hein
W J
WJ
Müller
G
G
Figulla
H R
HR
D000258:Adenovirus Infections, Human / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D000260:Adenoviruses, Human / Q000235:genetics / Q000472:pathogenicity*; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D004699:Endocardium / Q000473:pathology / Q000821:virology; D004770:Enterovirus / Q000235:genetics / Q000472:pathogenicity*; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D005260:Female; D015870:Gene Expression / Q000502:physiology; D005814:Genes, Viral / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D009206:Myocardium / Q000473:pathology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D014774:Virulence / Q000235:genetics