Prevalence of erythrovirus genotypes in the myocardium of patients with dilated cardiomyopathy

• Published in: Journal of medical virology Vol. 80; no. 7; pp. 1243 - 1251
• Main Authors: Kühl, U, Lassner, D, Pauschinger, M, Gross, U.M, Seeberg, B, Noutsias, M, Poller, W, Schultheiss, H.-P
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.07.2008; Wiley-Liss
• Subjects: Adult; Aged; Amino Acid Sequence; Base Sequence; Biological and medical sciences; Capsid Proteins - chemistry; Cardiomyopathy, Dilated - virology; dilated cardiomyopathy; Epidemiology; Erythrovirus; Erythrovirus - genetics; Erythrovirus - isolation & purification; Female; Fundamental and applied biological sciences. Psychology; Genotype; genotypes; Heart - virology; heart failure; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Molecular Sequence Data; Parvoviridae Infections - virology; Parvovirus B19; Prevalence; Sequence Alignment; Viral diseases; Viral Load; Virology; Human; Heart failure; Prevalence; genotypes; Cardiovascular disease; Genotype; Erythrovirus; Myocardial disease; Virus; Dilated cardiomyopathy; Parvoviridae; Heart disease; Molecular epidemiology; Myocardium; Parvovirinae
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.21187

Parvovirus B19 (PVB19) is a member of the human erythrovirus family detected frequently in endomyocardial biopsies from patients with dilated cardiomyopathy. Human erythroviruses cluster into three genotypes 1-3 which share a high degree of homology between major structural proteins and may cause indistinguishable infections clinically and serologically. In human cardiac tissue erythrovirus genotypes other than PVB19 have not yet been reported. Three hundred seventeen consecutive patients with symptomatic dilated cardiomyopathy (median left ventricular ejection fraction: 28.6%, range 5-45%) who underwent endomyocardial biopsy for the elucidation of the etiology, were analyzed using a new consensus PCR assay designed for the detection of the three erythrovirus genotype sequences. Endomyocardial biopsies of 151 (47.6%) patients were erythrovirus-positive. Genotype 1 specific sequences were detected in 43/151 (28.5%) of positive biopsy samples, whereas genotype 2-specific sequences so far considered rare in human disease and not yet been described in human heart tissue was identified in 108/151 (71.5%) of virus-positive endomyocardial biopsies with a preference in patients above 50 years of age. In spite of younger age, systolic left ventricular dysfunction of genotype 1-positive patients was significantly reduced as compared to genotype 2-positive patients (24.4 ± 10.4% vs. 31.0 ± 9.5%, P = 0.0001) at the initial presentation. The data show that two genetically distinct erythrovirus variants with a different age distribution are detectable in endomyocardial biopsies of patients with dilated cardiomyopathy. The erythrovirus genotype 2, not described previously in human heart tissue, is highly prevalent in the heart but the less prevalent genotype 1 is associated with more severe disturbed cardiac function. J. Med. Virol. 80: 1243-1251, 2008.