Absence of viral nucleic acids in early and late dilated cardiomyopathy.
OBJECTIVE
To investigate whether viral infection acts as a trigger factor for the development of dilated cardiomyopathy in genetically predisposed individuals with a family history of disease.


METHODS
Patients attending the cardiomyopathy unit in a cardiac tertiary referral centre.


METHODS
Nested polymerase chain reaction (nPCR) was used to determine whether enteroviral, adenoviral, or cytomegaloviral nucleic acids were detectable in the myocardium of 19 asymptomatic relatives of patients with dilated cardiomyopathy; all these relatives had echocardiographic abnormalities thought to represent early disease. Explanted hearts from patients with end stage dilated cardiomyopathy were also studied and were compared with 25 controls (ischaemic heart disease (21), valvar heart disease (2), hypertrophic cardiomyopathy (1), restrictive cardiomyopathy (1)). Myocardial tissue from two fatal cases of culture positive coxsackie myocarditis was used as a positive control.


RESULTS
No viral nucleic acid was detected in any group other than in those with myocarditis. Spiking of random wells with purified recombinant viral nucleic acids confirmed the sensitivity and reproducibility of the assays.


CONCLUSIONS
Myocardial viral infection is not detectable in relatives of patients with dilated cardiomyopathy who are suspected of having early disease. There is no evidence that viruses act as a trigger factor for initiating the dilated cardiomyopathy in these patients.
Mahon
N G
NG
Department of Cardiological Sciences, St George's Hospital Medical School, London SW17 0RE, UK.
Zal
B
B
Arno
G
G
Risley
P
P
Pinto-Basto
J
J
McKenna
W J
WJ
Davies
M J
MJ
Baboonian
C
C
D000256:Adenoviridae / Q000302:isolation & purification; D000257:Adenoviridae Infections / Q000150:complications; D000293:Adolescent; D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000235:genetics / Q000821:virology*; D002648:Child; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications; D018076:DNA, Complementary / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis*; D004770:Enterovirus / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000150:complications; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000235:genetics / Q000821:virology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques; D010375:Pedigree; D012367:RNA, Viral / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction
D018076:DNA, Complementary; D004279:DNA, Viral; D012367:RNA, Viral