Grumbach I M, Heim A, Pring-Akerblom P, Vonhof S, Hein W J, Müller G, Figulla H R
Department of Internal Medicine, Georg-August-Universität, Göttingen, Germany.
Acta Cardiol. 1999 Apr;54(2):83-8.
Enteroviruses were detected in up to 50% in myocardium of patients with myocarditis and dilated cardiomyopathy, the latter being considered as a result of a prior subclinical myocarditis. A wide range of other infectious agents are being discussed as pathogens, often only based on reports of single cases. Adenovirus genome was recently identified in a significant number in the myocardium of paediatric patients with myocarditis. However, data on the role of adenoviruses for the aetiopathogenesis of myocarditis in adult patients is missing so far. Therefore, we studied the prevalence of adenoviral and enteroviral genome in myocardium of adults with myocarditis and dilated cardiomyopathy.
15 patients were diagnosed at baseline with myocarditis, 16 patients with dilated cardiomyopathy according to clinical and histological criteria. Endomyocardial biopsies of these patients and 8 control patients with non-infectious heart diseases were evaluated by polymerase chain reactions for enterovirus and adenovirus genome.
Enteroviral genome was detected in 27.3% patients with myocarditis or dilated cardiomyopathy, whereas adenoviral genome was not identified in any patient. Samples from control subjects systematically yielded negative results.
From our data, it seems doubtful that adenoviruses are major pathogens of myocarditis or DCM, whereas enterovirus genome was identified in a significant number of patients with both diseases.
在心肌炎和扩张型心肌病患者的心肌中，肠道病毒的检出率高达50%，后者被认为是先前亚临床心肌炎的结果。其他多种感染因子也被作为病原体进行讨论，通常仅基于个别病例报告。最近在患有心肌炎的儿科患者的心肌中发现了大量腺病毒基因组。然而，迄今为止，关于腺病毒在成人患者心肌炎病因发病机制中的作用的数据尚缺。因此，我们研究了患有心肌炎和扩张型心肌病的成人心肌中腺病毒和肠道病毒基因组的流行情况。
根据临床和组织学标准，15例患者在基线时被诊断为心肌炎，16例患者被诊断为扩张型心肌病。通过聚合酶链反应对这些患者以及8例患有非感染性心脏病的对照患者的心内膜活检组织进行肠道病毒和腺病毒基因组评估。
在患有心肌炎或扩张型心肌病的患者中，27.3%检测到肠道病毒基因组，而在任何患者中均未鉴定出腺病毒基因组。对照受试者的样本系统地产生阴性结果。
从我们的数据来看，腺病毒是否为心肌炎或扩张型心肌病的主要病原体似乎存疑，而在大量患有这两种疾病的患者中都鉴定出了肠道病毒基因组。
