Cardiac myocytes of hearts from patients with end-stage dilated cardiomyopathy do not contain Borrelia burgdorferi DNA.
OBJECTIVE
To determine if end-stage dilated cardiomyopathy (DCM) is associated with the presence of Lyme disease causing spirochete Borrelia burgdorferi in the myocardium, we used nested polymerase chain reaction to detect B burgdorferi DNA in myocardial samples from explanted hearts of patients with end-stage DCM. Patients originated from endemic areas for Lyme disease (Bavaria, Lower Saxony, Germany).


RESULTS
This was a retrospective study. Polymerase chain reaction was used to detect the specific B burgdorferi recombinant outer surface protein A (OspA) gene in myocardial tissue from 68 patients with end-stage DCM who had undergone heart transplantation. The clinical history of Lyme disease, the presence of Borrelia burgdorferi OspA, and antibodies against OspA in myocardial tissue and serum were investigated. B burgdorferi DNA was not detected in any of the 68 human hearts. Immunoglobulin G antibodies against specific B burgdorferi antigens were observed in 3 (12.5%) of 24 patients. In contrast, 4 hearts from rats experimentally infected with B burgdorferi were all positive for OspA DNA as measured by polymerase chain reaction.


CONCLUSIONS
Our data show that cardiac myocytes of hearts obtained from subjects with end-stage DCM did not contain B burgdorferi DNA as investigated by polymerase chain reaction. However, B burgdorferi shows a high affinity for myocardial tissue as shown by the animal studies, indicating that myocardial infections are nevertheless possible.
Suedkamp
M
M
Clinic for Cardiac Surgery, University of Goettinger, Cologne, Germany. michael.suedkamp@medizin.uni-koeln.de
Lissel
C
C
Eiffert
H
H
Flesch
M
M
Boehm
M
M
Mehlhorn
U
U
Thomssen
R
R
de Vivie
E R
ER
D000818:Animals; D000907:Antibodies, Bacterial; D001425:Bacterial Outer Membrane Proteins / Q000302:isolation & purification; D015748:Borrelia burgdorferi Group / Q000235:genetics / Q000302:isolation & purification*; D002311:Cardiomyopathy, Dilated / Q000382:microbiology*; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006321:Heart / Q000382:microbiology*; D006801:Humans; D008297:Male; D009206:Myocardium / Q000166:cytology*; D016133:Polymerase Chain Reaction; D051381:Rats; D017208:Rats, Wistar; D011994:Recombinant Proteins; D012189:Retrospective Studies
D000907:Antibodies, Bacterial; D001425:Bacterial Outer Membrane Proteins; D004269:DNA, Bacterial; D011994:Recombinant Proteins