Cardiotropic viruses in the myocardium of children with end-stage heart disease.

Abstract

BACKGROUND:

Transplantation has become a lifesaving procedure for children with end-stage heart failure. The long-term outcome for children who undergo transplantation has been of considerable interest, but the causes of graft failure and death are largely unknown, and the role of pre-transplant viral infection is unclear.

METHODS:

Myocardial samples from 80 explanted hearts from children with end-stage heart disease caused by congenital heart disease (CHD), cardiomyopathy, or chronic rejection were analyzed using polymerase chain reaction and reverse-transcriptase polymerase chain reaction for cardiotropic viruses using virus-specific primers. We used immunohistochemical analysis of cytoskeletal proteins to evaluate myocyte architecture.

RESULTS:

We identified parvoviral genomes in 6 patients (3 with CHD and 3 with cardiomyopathy). We detected no other viruses. Immunohistochemistry showed normal staining for key components of the cytoskeleton/sarcolemma, sarcomere, and nuclear membrane in the 6 virus-positive samples. The clinical outcome of these children was worse (4 long-term survivors, but 2 deaths) than for individuals without the genome.

CONCLUSIONS:

Detecting viruses within the myocardium at the point of end-stage heart failure is not common, regardless of the primary pathology. However, the presence of viruses may result in poor outcome for the patient.

• Authors: Paola Francalanci, Jamie L Chance, Matteo Vatta, Shinawe Jimenez, Hua Li, Jeffrey A Towbin, Neil E Bowles
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 23 Issue 9 Pg. 1046-52 (Sep 2004) ISSN: 1053-2498 [Print] United States
• PMID: 15454170 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Child
• Female
• Heart (virology)
• Heart Defects, Congenital (virology)
• Heart Diseases (virology)
• Heart Transplantation
• Humans
• Immunohistochemistry
• Male
• Parvoviridae Infections (diagnosis)
• Reverse Transcriptase Polymerase Chain Reaction
• Sequence Analysis, DNA
• Virus Diseases (diagnosis)