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September 19, 2026Journal of the American College of CardiologyOpen Access

Detection of viruses in myocardial tissues by polymerase chain reaction

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Key result

PCR detects viral genomes in ~38% of myocarditis samples, identifying adenovirus as the primary etiology.

  • n=773

Authors

NBNeil E. BowlesNorthwestern UniversityJNJiyuan NiHebei Medical UniversityDKDebra L. KearneyPediatric Cardiology

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Overview

Observational study uncovers adenovirus as the primary viral genome in myocarditis and dilated cardiomyopathy, suggesting a shift from enterovirus as the leading etiology.

Key Points

  • To identify viral genomes in cardiac tissue and blood using polymerase chain reaction to determine the predominant viral etiologies of myocarditis across age groups.
  • Analyzed cardiac tissue samples (endomyocardial biopsy, explant, or autopsy) from patients with myocarditis (n = 624) and dilated cardiomyopathy (n = 149) across six age groups: neonates (n = 116), infants (n = 191), toddlers (n = 87), children (n = 110), adolescents (n = 92), and adults (n = 177).
  • Performed polymerase chain reaction (PCR) and reverse transcription PCR to detect genomes of enterovirus, adenovirus, CMV, HSV, EBV, parvovirus, RSV, and influenza A.
  • Viral genomes were amplified in 239 of 624 myocarditis samples (38%), including 26 dual infections, with adenovirus (n = 142) and enterovirus (n = 85) being the most prevalent, followed by CMV (n = 18), parvovirus (n = 6), HSV (n = 5), influenza A (n = 5), EBV (n = 3), and RSV (n = 1).
  • Viral genomes were identified in 30 of 149 dilated cardiomyopathy samples (20%), consisting exclusively of adenovirus (n = 18) and enterovirus (n = 12).

Study Design

Type

Observational (n=773)

PICO

P
Population
773 patients across all age groups, including 624 with myocarditis and 149 with dilated cardiomyopathy, who underwent cardiac sample analysis for viral genomes.
E
Exposure / Comparator
Polymerase chain reaction (PCR) analysis
O
Primary Outcome
Detection of viral genomes in cardiac samples

Cite This Study

Bowles et al. (2003) conducted an observational in Myocarditis and dilated cardiomyopathy (n=773). Polymerase chain reaction (PCR) analysis was evaluated on Detection of viral genomes in cardiac samples. Polymerase chain reaction detected viral genomes in 38% of myocarditis samples and 20% of dilated cardiomyopathy samples, identifying adenovirus as the most common viral etiology.

synapsesocial.com/papers/6aadfe73caa0b306db0bb28ahttps://doi.org/10.1016/s0735-1097(03)00648-x
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Virologic Studies in Children With Acute Myocarditis1968 · 46 citations
  2. 2Viral Infection of the Myocardium in Endocardial Fibroelastosis1997 · 126 citations