Department of Cardiology and Pneumology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institut für Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany.
Department of Cardiology and Pneumology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institut für Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany.
J Clin Virol. 2015 Feb;63:1-5. doi: 10.1016/j.jcv.2014.11.026. Epub 2014 Nov 29.
Human herpesvirus 6 (HHV-6) A and B are lymphotropic viruses with life-long persistence, primarily associated with non-cardiac diseases, and discussed as a possible etiologic factor of myocarditis and cardiomyopathy.
To analyze the long-term spontaneous course of cardiac patients suffering from suspected inflammatory cardiomyopathy (CMi) with persisting HHV-6 A and B infections by follow-up biopsies.
We prospectively evaluated patients (n=73) with biopsy-proven viral HHV-6 A and B infection in endomyocardial biopsies (EMBs), followed up by reanalysis of EMBs and left ventricular ejection fraction (LV-EF) measurements after a median period of 8.8 months (range 4-73 months). Beyond, we studied HHV-6 prevalence in isolated peripheral blood cells (PBCs) and HHV-6 species in EMBs. HHV-6 species-specific cellular infection sites within the myocardium were identified by immunohistochemistry (IHC).
We identified 73 patients with cardiac HHV-6 A and B persistence or newly detected in follow-up EMB (95.0% B). Proof of HHV-6 in PBCs was primarily associated with A. Persistence of cardiac HHV-6 B genome was significantly associated with cardiac dysfunction at follow-up (LV-EF deteriorated from 58.2±16.0 to 51.8±17.2%, p<0.001), and LV improvement was observed when HHV-6 B persistence resolved (LV-EF increased from 54.9±15.4 to 60.7±13.1%, p<0.001).
Persistence of cardiac HHV-6 B genomes was significantly associated with cardiac dysfunction, and hemodynamic parameters improved in association with HHV-6 B clearance.
人类疱疹病毒 6 型（HHV-6）A 和 B 是具有终生持续性的淋巴亲嗜性病毒，主要与非心脏疾病相关，并被认为是心肌炎和心肌病的可能病因。
通过随访活检分析持续性 HHV-6 A 和 B 感染的疑似炎症性心肌病（CMi）心脏患者的长期自然病程。
我们前瞻性评估了 73 例经心内膜心肌活检（EMB）证实存在病毒 HHV-6 A 和 B 感染的患者，中位随访时间为 8.8 个月（范围为 4-73 个月），并再次分析 EMB 和左心室射血分数（LV-EF）。此外，我们还研究了孤立外周血单个核细胞（PBC）中的 HHV-6 流行情况以及 EMB 中的 HHV-6 种属。通过免疫组织化学（IHC）鉴定心肌内 HHV-6 种属特异性细胞感染部位。
我们在随访的 EMB 中发现 73 例患者存在心脏 HHV-6 A 和 B 持续感染或新发现（95.0%为 B）。PBC 中的 HHV-6 存在主要与 A 相关。心脏 HHV-6 B 基因组的持续存在与随访时的心脏功能障碍显著相关（LV-EF 从 58.2±16.0 恶化至 51.8±17.2%，p<0.001），当 HHV-6 B 持续存在得到解决时，LV 得到改善（LV-EF 从 54.9±15.4 增加至 60.7±13.1%，p<0.001）。
心脏 HHV-6 B 基因组的持续存在与心脏功能障碍显著相关，并且与 HHV-6 B 清除相关的血流动力学参数得到改善。
