Enteroviral RNA was detected in only 3.1% of myocardial specimens from children with end-stage idiopathic dilated cardiomyopathy and 0% of control specimens, indicating no significant role.
Observational (n=67)
Does enteroviral persistence play a significant role in the pathogenesis of end-stage idiopathic dilated cardiomyopathy in children and adolescents?
Enteroviral persistence does not appear to be a significant factor in the progression of idiopathic dilated cardiomyopathy to end-stage heart failure in children and adolescents.
Absolute Event Rate: 3.1% vs 0%
Medical records and archival myocardial specimens of 33 children and adolescents with end-stage idiopathic dilated cardiomyopathy (IDCM) were collected to evaluate retrospectively the potential role of enteroviral persistence in the pathogenesis of IDCM. The clinical history and laboratory assessment of each patient were reviewed carefully in order to obtain information on the nature and etiology of infections in the past and at the time of diagnosis of cardiomyopathy. Sixty-four formaldehyde-fixed, paraffin-embedded myocardial specimens, obtained from endomyocardial biopsies (n = 5), explanted hearts (n = 10), or autopsies (n = 49), were studied by the polymerase chain reaction (PCR) and by in situ hybridization to detect enteroviral RNA in the specimens. Control specimens included 34 formaldehyde-fixed, paraffin-embedded myocardial specimens from children with other cardiomyopathies, metabolic diseases, structural heart defects, or various noncardiac malignancies. The presence of cellular RNA in the specimens was confirmed by amplification of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA or beta-actin mRNA as positive controls. Only one specimen from the 32 IDCM patients with appropriate myocardial specimens was positive for enteroviral RNA by PCR. Sequence analysis of the amplified viral segment showed a significant degree of homology between the viral sequence and echovirus 1. One specimen from the control patients also appeared positive by PCR, but sequence analysis of the amplified viral segment revealed it as rhinovirus 16. The results do not indicate any significant role for enteroviral persistence in end-stage childhood IDCM, although they need to be confirmed using a prospective study with fresh frozen specimens. However, mechanisms other than viral persistence may be more important in the progression of IDCM to end-stage heart failure in this age group.
Arola et al. (Tue,) conducted a observational in End-stage idiopathic dilated cardiomyopathy (n=67). Polymerase chain reaction (PCR) and in situ hybridization vs. Specimens from children with other cardiomyopathies, metabolic diseases, structural heart defects, or noncardiac malignancies was evaluated on Detection of enteroviral RNA. Enteroviral RNA was detected in only 3.1% of myocardial specimens from children with end-stage idiopathic dilated cardiomyopathy and 0% of control specimens, indicating no significant role.