Department of Cardiology, University Hospital Gießen & Marburg, 35043, Marburg, Germany,
Heart Fail Rev. 2013 Nov;18(6):683-702. doi: 10.1007/s10741-012-9357-4.
Cardiotropic viruses have been implicated as major pathogenetic agents in acute and chronic forms of myocarditis. By the introduction of molecular tools, such as (RT-) polymerase chain reaction ((RT-) PCR) and in situ hybridization in the diagnosis of inflammatory heart disease, genomes of various RNA and DNA viruses comprising enteroviruses, adenoviruses, parvovirus B19 (B19V) and herpesviruses (EBV, HHV6, HCMV) were detected in endomyocardial biopsies of patients with myocarditis and dilated cardiomyopathy. Meanwhile, it is known that the outcome of a virus infection in the heart resulting in myocarditis is determined by genetic host factors as well as by the viral pathogenicity which considerably varies in the different virus infections. A considerable portion of our knowledge about the etiopathogenetic mechanisms in viral heart disease is derived from animal studies. Whereas the evolvement of cardiac inflammation in enterovirus infections is guided by viral cytotoxicity and virus persistence, in herpesvirus infections, the pathophysiology is rather determined by primary immune-mediated pathogenicity. By investigation of immunocompetent and gene-targeted mice, valuable new insights into host and virus factors relevant for the control of cardiac viral infection and inflammation were gained which are reviewed in this paper.
心肌病毒已被认为是急性和慢性心肌炎的主要病原体。通过引入分子工具，如（RT）聚合酶链反应（（RT）PCR）和原位杂交在炎症性心脏病的诊断，各种 RNA 和 DNA 病毒的基因组包括肠道病毒、腺病毒、细小病毒 B19（B19V）和疱疹病毒（EBV、HHV6、HCMV）已在心肌炎和扩张型心肌病患者的心肌活检中检测到。同时，已知病毒感染导致心肌炎的结果取决于遗传宿主因素以及病毒的致病性，不同病毒感染的致病性差异很大。我们对病毒性心脏病发病机制的认识很大一部分来自动物研究。虽然肠道病毒感染中心脏炎症的发展是由病毒细胞毒性和病毒持续性决定的，但在疱疹病毒感染中，病理生理学主要由原发性免疫介导的致病性决定。通过对免疫功能正常和基因靶向小鼠的研究，获得了有关控制心脏病毒感染和炎症的宿主和病毒因素的宝贵新见解，本文对此进行了综述。
