Aggravation of left ventricular dysfunction in patients with biopsy-proven cardiac human herpesvirus A and B infection
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Aggravation of left ventricular dysfunction in patients with biopsy-proven cardiac human herpesvirus A and B infection. / Escher, F; Kühl, U; Gross, U; Westermann, D; Poller, W; Tschöpe, C; Lassner, D; Schultheiss, H-P.
In: J CLIN VIROL, Vol. 63, 02.2015, p. 1-5.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Aggravation of left ventricular dysfunction in patients with biopsy-proven cardiac human herpesvirus A and B infection
AU - Escher, F
AU - Kühl, U
AU - Gross, U
AU - Westermann, D
AU - Poller, W
AU - Tschöpe, C
AU - Lassner, D
AU - Schultheiss, H-P
N1 - Copyright © 2014 Elsevier B.V. All rights reserved.
PY - 2015/2
Y1 - 2015/2
N2 - BACKGROUND: Human herpesvirus 6 (HHV-6) A and B are lymphotropic viruses with life-long persistence, primarily associated with non-cardiac diseases, and discussed as a possible etiologic factor of myocarditis and cardiomyopathy.OBJECTIVE: To analyze the long-term spontaneous course of cardiac patients suffering from suspected inflammatory cardiomyopathy (CMi) with persisting HHV-6 A and B infections by follow-up biopsies.STUDY DESIGN: We prospectively evaluated patients (n=73) with biopsy-proven viral HHV-6 A and B infection in endomyocardial biopsies (EMBs), followed up by reanalysis of EMBs and left ventricular ejection fraction (LV-EF) measurements after a median period of 8.8 months (range 4-73 months). Beyond, we studied HHV-6 prevalence in isolated peripheral blood cells (PBCs) and HHV-6 species in EMBs. HHV-6 species-specific cellular infection sites within the myocardium were identified by immunohistochemistry (IHC).RESULTS: We identified 73 patients with cardiac HHV-6 A and B persistence or newly detected in follow-up EMB (95.0% B). Proof of HHV-6 in PBCs was primarily associated with A. Persistence of cardiac HHV-6 B genome was significantly associated with cardiac dysfunction at follow-up (LV-EF deteriorated from 58.2±16.0 to 51.8±17.2%, p<0.001), and LV improvement was observed when HHV-6 B persistence resolved (LV-EF increased from 54.9±15.4 to 60.7±13.1%, p<0.001).CONCLUSIONS: Persistence of cardiac HHV-6 B genomes was significantly associated with cardiac dysfunction, and hemodynamic parameters improved in association with HHV-6 B clearance.
AB - BACKGROUND: Human herpesvirus 6 (HHV-6) A and B are lymphotropic viruses with life-long persistence, primarily associated with non-cardiac diseases, and discussed as a possible etiologic factor of myocarditis and cardiomyopathy.OBJECTIVE: To analyze the long-term spontaneous course of cardiac patients suffering from suspected inflammatory cardiomyopathy (CMi) with persisting HHV-6 A and B infections by follow-up biopsies.STUDY DESIGN: We prospectively evaluated patients (n=73) with biopsy-proven viral HHV-6 A and B infection in endomyocardial biopsies (EMBs), followed up by reanalysis of EMBs and left ventricular ejection fraction (LV-EF) measurements after a median period of 8.8 months (range 4-73 months). Beyond, we studied HHV-6 prevalence in isolated peripheral blood cells (PBCs) and HHV-6 species in EMBs. HHV-6 species-specific cellular infection sites within the myocardium were identified by immunohistochemistry (IHC).RESULTS: We identified 73 patients with cardiac HHV-6 A and B persistence or newly detected in follow-up EMB (95.0% B). Proof of HHV-6 in PBCs was primarily associated with A. Persistence of cardiac HHV-6 B genome was significantly associated with cardiac dysfunction at follow-up (LV-EF deteriorated from 58.2±16.0 to 51.8±17.2%, p<0.001), and LV improvement was observed when HHV-6 B persistence resolved (LV-EF increased from 54.9±15.4 to 60.7±13.1%, p<0.001).CONCLUSIONS: Persistence of cardiac HHV-6 B genomes was significantly associated with cardiac dysfunction, and hemodynamic parameters improved in association with HHV-6 B clearance.
KW - Adult
KW - Aged
KW - Biopsy
KW - Blood/virology
KW - Cardiomyopathies/pathology
KW - Female
KW - Heart/virology
KW - Herpesvirus 6, Human/classification
KW - Humans
KW - Immunohistochemistry
KW - Male
KW - Middle Aged
KW - Myocardium/pathology
KW - Prospective Studies
KW - Roseolovirus Infections/complications
KW - Ventricular Dysfunction, Left/physiopathology
U2 - 10.1016/j.jcv.2014.11.026
DO - 10.1016/j.jcv.2014.11.026
M3 - SCORING: Journal article
C2 - 25600595
VL - 63
SP - 1
EP - 5
JO - J CLIN VIROL
JF - J CLIN VIROL
SN - 1386-6532
ER -