Key result
Enterovirus RNA and capsid protein VP1 were detected in 24.2% and 48.5% of patients with chronic rheumatic heart disease, respectively, compared to 0% in comparison cases.
Why the study?
Is enterovirus infection present in the valvular tissue of patients with chronic rheumatic heart disease compared to other valve diseases?
Case-Control (n=53)
Is enterovirus infection present in the valvular tissue of patients with chronic rheumatic heart disease compared to other valve diseases?
Absolute Event Rate: 24.2% vs 0%
The detection of enterovirus RNA replication and protein synthesis in chronic rheumatic heart disease valves suggests a potential etiological role for enterovirus in its pathogenesis.
Should not change rheumatic heart disease management; leaves open a possible enteroviral role pending prospective studies.
AIMS: To investigate the involvement of enterovirus infection in chronic, rheumatic heart disease. METHODS AND RESULTS: Formalin-fixed, paraffin-embedded, surgical samples of valve tissue were examined for the presence of enteroviral RNA and virus capsid protein VP1 by in situ hybridization and immunostaining. Of 53 cases, 33 were patients with chronic rheumatic heart disease and 20 had Marfan's syndrome or degenerative valve disease. Enterovirus RNA was detected in 8 (24.2%) of 33 patients with chronic rheumatic heart disease by in situ hybridization using strand-specific oligonucleotide probes, complementary to conserved sequences in enterovirus genomic (positive strand) RNA. The replication template (negative strand) RNA also was found in seven of these eight cases. The viral capsid protein VP1 was detected in 16 (48.5%) of 33 patients with chronic rheumatic heart disease by immunohistochemistry and correlated with viral RNA detection. Virus was localized generally to valvular tissue. Neither viral RNA nor capsid protein VP1 were found in valvular tissue from any of the 20 comparison cases. CONCLUSIONS: This is the first demonstration of detection and localization of both enterovirus RNA and capsid protein in chronic rheumatic heart disease. The presence of negative strand RNA and VP1 indicates enteroviral RNA replication and protein synthesis and suggests an aetiological role of enterovirus in the pathogenesis of chronic rheumatic heart disease.
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Y Li (2002) conducted a case-control in Chronic rheumatic heart disease (n=53). Enterovirus infection vs. Patients with Marfan's syndrome or degenerative valve disease was evaluated on Detection of enterovirus RNA. Enterovirus RNA and capsid protein VP1 were detected in 24.2% and 48.5% of patients with chronic rheumatic heart disease, respectively, compared to 0% in comparison cases.
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