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Detection of enteroviruses in endomyocardial biopsy by molecular approach

J Petitjean1, H Kopecka, F Freymuth

  • 1Laboratoire de Virologie, CHRU Caen, France.

Insights

Enteroviruses are common causes of myocarditis and cardiomyopathy. This study detected enteroviral RNA in heart biopsies, suggesting a link between viral infection and heart muscle diseases.

Area of Science:

  • Cardiology
  • Virology
  • Molecular Biology

Background:

  • Enteroviruses are frequently linked to myocarditis and cardiomyopathy.
  • Persistent enterovirus infection is suspected in chronic heart conditions, with viral RNA found in the myocardium.
  • Gene amplification techniques offer direct detection of enteroviral sequences in cardiac tissue.

Purpose of the Study:

  • To investigate the presence of enteroviral sequences in endomyocardial biopsies from patients with various cardiomyopathies and myocarditis.
  • To establish a potential correlation between enteroviral infection and the development of heart muscle diseases.
  • To determine if enteroviral infection is directly associated with idiopathic dilated cardiomyopathy.

Main Methods:

  • Utilized polymerase chain reaction (PCR) with primers targeting conserved 5' non-coding regions of the enterovirus genome for broad detection.
  • Employed hybridization with a specific riboprobe derived from internal 5' non-coding sequences to confirm amplified products.
  • Analyzed endomyocardial biopsy samples from 105 patients across six groups: idiopathic dilated cardiomyopathy, alcoholic cardiomyopathy, myocarditis, multifactorial cardiomyopathy, immunosuppressive therapy, and a control group.

Main Results:

  • Enteroviral RNA was detected in a significant percentage of patients across different cardiomyopathy groups, including 66.7% in idiopathic dilated cardiomyopathies and 52.9% in alcoholic cardiomyopathies.
  • The highest detection rate (100%) was observed in patients receiving immunosuppressive therapy.
  • A notable 39.1% of the control group also showed positive results, indicating potential challenges in establishing direct causality.

Conclusions:

  • The study suggests a positive association between viral infections and cardiomyopathies.
  • While enteroviruses are implicated, a direct causal link between enterovirus infection and idiopathic dilated cardiomyopathy could not be definitively established.
  • Further research is warranted to elucidate the precise role of enteroviruses in the pathogenesis of specific cardiac conditions.

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