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Aggravation of left ventricular dysfunction in patients with biopsy-proven cardiac human herpesvirus A and B

F Escher1, U Kühl1, U Gross2

  • 1Department of Cardiology and Pneumology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institut für Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany.

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
|January 21, 2015
PubMed

Insights

Persistent Human Herpesvirus 6 (HHV-6) B infection in the heart is linked to cardiac dysfunction. Clearance of HHV-6 B was associated with improved heart function in patients with inflammatory cardiomyopathy.

Area of Science:

  • Cardiology
  • Virology
  • Immunology

Background:

  • Human herpesvirus 6 (HHV-6) A and B are lymphotropic viruses known for lifelong persistence.
  • These viruses are primarily linked to non-cardiac conditions but are suspected contributors to myocarditis and cardiomyopathy.

Purpose of the Study:

  • To investigate the long-term effects of persistent HHV-6 A and B infections on cardiac function.
  • To analyze the spontaneous course of inflammatory cardiomyopathy in patients with HHV-6 persistence using follow-up endomyocardial biopsies.

Main Methods:

  • Prospective evaluation of 73 patients with biopsy-proven HHV-6 A/B infection in endomyocardial biopsies (EMBs).
  • Follow-up analysis of EMBs and left ventricular ejection fraction (LV-EF) measurements after a median of 8.8 months.
  • Investigation of HHV-6 prevalence in peripheral blood cells (PBCs) and identification of infection sites within the myocardium via immunohistochemistry (IHC).

Main Results:

  • Cardiac HHV-6 A and B persistence was identified in 73 patients, with HHV-6 B being predominant (95.0%).
  • Persistent cardiac HHV-6 B infection significantly correlated with worsened cardiac dysfunction (LV-EF decline).
  • Resolution of HHV-6 B persistence was associated with significant improvement in LV-EF.

Conclusions:

  • Persistence of cardiac HHV-6 B genomes is a significant factor in cardiac dysfunction.
  • Hemodynamic parameters in patients with inflammatory cardiomyopathy improve following HHV-6 B clearance.
Abstract

Keywords:
HHV6HeartHeart failureInflammatory cardiomyopathyPrognosis

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