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The epidemiology of viral heart disease
Insights
Enteroviruses, particularly Coxsackie B viruses, are key causes of myopericarditis and may contribute to dilated cardiomyopathy. Viral heart disease is increasingly recognized in specific patient groups.
Area of Science:
- Cardiology
- Virology
- Pathology
Background:
- Enteroviruses, especially Coxsackie B viruses, are primary causes of myopericarditis.
- Viral infections may play a role in the pathogenesis of dilated cardiomyopathy, atherosclerosis, and myocardial infarction.
- Myopericarditis is often mild or subclinical, making incidence data difficult to obtain.
Purpose of the Study:
- To summarize the role of enteroviruses in myopericarditis and dilated cardiomyopathy.
- To discuss the incidence and prognosis of myopericarditis.
- To highlight emerging viral heart diseases in specific populations.
Main Methods:
- Review of existing literature on enteroviral infections and cardiac diseases.
- Analysis of histopathological data from autopsy cases using the Dallas criteria.
- Examination of findings in heart transplant recipients and AIDS patients.
Main Results:
- A 1.06% incidence of myopericarditis was found in unselected autopsy cases.
- Enteroviral RNA detected in biopsies and explanted hearts supports a link between myopericarditis and dilated cardiomyopathy.
- New patterns of viral heart disease are observed in heart transplant recipients and AIDS patients.
Conclusions:
- Enteroviruses are significant etiological agents in myopericarditis and potentially in dilated cardiomyopathy.
- While prognosis is generally favorable, viral heart disease presents unique challenges in immunocompromised and transplanted individuals.
- Further research is needed to fully elucidate the spectrum of viral heart disease.
Abstract:
The enteroviruses, especially the Coxsackie B viruses, predominate as causative agents in myopericarditis and may be involved in the pathogenesis of dilated cardiomyopathy. Some studies suggest that these and other viruses might be implicated even in atherosclerosis and myocardial infarction. True incidence data of myopericarditis in the population at large are hardly feasible, since the disease is most often mild or subclinical. The long-term prognosis is favorable even in a majority of hospital-treated patients. A recent histopathological study of unselected autopsy cases employing the "Dallas criteria" for a diagnosis shows a myopericarditis incidence of 1.06 per cent. A link between myopericarditis and dilated cardiomyopathy is supported by findings of enteroviral RNA in biopsies and explanted hearts in the latter condition. A partly new panorama of viral heart disease is emerging in heart transplant recipients and AIDS patients.