The relationship of myocarditis to dilated cardiomyopathy

Area of Science:

• Cardiology
• Virology
• Pathology

Background:

• Dilated cardiomyopathy is a significant cause of heart failure.
• The role of viral infections in the pathogenesis of cardiomyopathy requires further elucidation.
• Coxsackie B viruses are known potential etiological agents for myocarditis.

Observation:

• Three patients with congestive cardiomyopathy exhibited high neutralizing antibody titers to Coxsackie B viruses.
• Post-mortem examination revealed chronic inflammation of the myocardium in these patients.
• Ten control patients with cardiac failure from other causes did not show similar myocardial inflammation.

Findings:

• The presence of Coxsackie B virus antibodies and myocardial inflammation provides evidence for viral involvement in dilated cardiomyopathy.
• One patient presented with co-occurring pulmonary veno-occlusive disease, a condition previously linked to myocarditis.
• A Coxsackie B virus etiology is postulated for the co-occurrence of myocarditis and pulmonary veno-occlusive disease in this patient.

Implications:

• These findings strengthen the hypothesis that Coxsackie B viral infections play a role in the development of some cases of dilated cardiomyopathy.
• Further research into viral etiologies is warranted for understanding and potentially treating specific forms of cardiomyopathy.
• The association with pulmonary veno-occlusive disease suggests a broader impact of Coxsackie B virus infection on cardiovascular health.