Idiopathic dilated cardiomyopathy and persistent viral infection: lack of association in a controlled study using a quantitative assay.
BACKGROUND
It remains unclear whether idiopathic dilated cardiomyopathy (DCM) might ensue as the consequence of viral myocarditis, due to viral persistence in cardiomyocytes. To address this issue, we quantified the levels of enterovirus, Epstein-Barr virus (EBV), Herpes Simplex Virus-1 (HSV-1), Herpes Simplex Virus-2 (HSV-2), adenovirus and parvovirus B19 genomes in endomyocardial biopsies (EMBs) from patients with DCM, active myocarditis and controls.


METHODS
Real-time polymerase chain reaction (PCR)-based methods using TaqMan probes were developed for the quantitative detection of viral genomes in EMBs from 35 patients with DCM and 17 with active myocarditis. A control group included 20 surgical patients with valve or coronary artery disease.


RESULTS
None of the 72 samples tested positive for enteroviruses, EBV, HSV-1 or -2. One DCM patient tested positive for adenovirus. Of notice, 20/52 (38%) of patients with cardiomyopathy and 8/20 (40%) of controls were positive for parvovirus B19; no significant differences in viral titre were detected between groups.


CONCLUSIONS
Our preliminary results disfavour the hypothesis that persistent myocardial viral infection might be a frequent cause of DCM. The detection of parvovirus B19 from both cardiomyopathy and non-cardiomyopathy patients supports the notion that this virus is widely spread in the population.
Molecular Medicine Laboratory, International Centre for Genetic Engineering and Biotechnology, Padriciano 99, Trieste, Italy.
Silvia
S
Moimas
Serena
S
Zacchigna
Marco
M
Merlo
Alessandra
A
Buiatti
Marco
M
Anzini
Lorella
L
Dreas
Alessandro
A
Salvi
Andrea
A
Di Lenarda
Mauro
M
Giacca
Gianfranco
G
Sinagra
D000256:Adenoviridae / Q000302:isolation & purification; D000328:Adult; D000704:Analysis of Variance; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000821:virology; D004699:Endocardium / Q000821:virology*; D004770:Enterovirus / Q000302:isolation & purification; D005260:Female; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000821:virology; D016732:Parvovirus B19, Human / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D014777:Virus Diseases / Q000150:complications*