Epstein-Barr virus genome was detected in the myocytes of 6.3% of patients with inflammatory cardiomyopathy, who experienced progressive cardiac dysfunction despite conventional therapy.
Observational (n=142)
Can laser capture microdissection detect Epstein-Barr virus genome specifically in myocytes of patients with inflammatory cardiomyopathy?
Detection of EBV genome specifically within myocytes supports a direct cytopathic role for EBV in inflammatory cardiomyopathy.
BACKGROUND: The causal role of Epstein-Barr virus (EBV) in inflammatory cardiomyopathy (IC) is still unclear, because this virus is present in latently infected circulating B lymphocytes in 90% of adults. Laser capture microdissection (LCM) has been applied on endomyocardial biopsy samples from patients with IC to assess the presence of EBV genome in separately dissected lymphocytes and myocytes. METHODS AND RESULTS: Among 142 patients with cardiac dilation and dysfunction and a histological and immunohistochemical diagnosis of myocarditis, 44 had a myocardial viral infection detected by polymerase chain reaction on frozen endomyocardial biopsy samples. In 9 of them, the virus detected was EBV. LCM was performed on 5-microm-thick paraffin sections of EBV-infected hearts. Lymphocytes and myocytes were microdissected and analyzed separately by polymerase chain reaction analysis on DNA extracted from the collected cells. Blood and myocardial samples from patients with positive and negative serology for EBV were used as controls. EBV genome was detected in myocytes but not in infiltrating lymphocytes of patients, nor in myocardial samples from controls. Despite full conventional antifailure therapy, a progressive cardiac dilation and dysfunction was documented in patients with EBV-related IC at a mean of 31+/-14 months of follow-up. CONCLUSIONS: Intramyocyte detection of EBV can be obtained by LCM in up to 6.3% of patients with IC. This supports a cytopathic EBV role and suggests the opportunity for an antiviral/immunomodulatory therapy.
Chimenti et al. (Tue,) conducted a observational in Inflammatory cardiomyopathy (n=142). Epstein-Barr virus (EBV) myocardial infection vs. Controls with positive and negative serology for EBV was evaluated on Intramyocyte detection of EBV genome. Epstein-Barr virus genome was detected in the myocytes of 6.3% of patients with inflammatory cardiomyopathy, who experienced progressive cardiac dysfunction despite conventional therapy.
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