Nowalany-Kozielska Ewa, Kozieł Monika, Domal-Kwiatkowska Dorota, Wojciechowska Celina, Jacheć Wojciech, Kawecki Damian, Tomasik Andrzej, Przywara-Chowaniec Brygida, Węglarz Ludmiła, Reichman-Warmusz Edyta, Wojnicz Romuald
Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland.
Intervirology. 2015;58(6):350-6. doi: 10.1159/000443375. Epub 2016 Feb 5.
The impact of myocardial viral persistence on the clinical outcome of patients with dilated cardiomyopathy (DCM) is still open to question.
Fifty-two patients with DCM were enrolled and followed for a median of 3.8 years with respect to death or heart transplantation. Studied patients were clinically stable for at least 6 months before hospitalization. They underwent coronary angiography and endomyocardial biopsy. Specimens were examined by histo- and immunohistochemistry, and the viral genomes of parvovirus B19, cytomegalovirus (CMV), Coxsackie B virus (CVB), and hepatitis B and C viruses were studied by real-time polymerase chain reaction.
Forty-two out of 52 patients were available for clinical follow-up. The viral genome was detected in the myocardium of 32 out of 42 patients. Among the viruses studied, CMV and CVB were the most frequently found. Nine out of 42 patients achieved the predefined study end point. No statistically significant correlation was found between the presence of a persistent viral genome and study end point. No statistically significant relationship between viral genomes studied and immunohistology results was detected.
High prevalence of a viral genome in the myocardium of patients with DCM did not have an influence on their long-term clinical outcome.
心肌病毒持续存在对扩张型心肌病（DCM）患者临床结局的影响仍存在疑问。
纳入52例DCM患者，随访其死亡或心脏移植情况，中位随访时间为3.8年。研究对象在住院前临床稳定至少6个月。他们接受了冠状动脉造影和心内膜心肌活检。标本进行了组织学和免疫组织化学检查，并通过实时聚合酶链反应研究了细小病毒B19、巨细胞病毒（CMV）、柯萨奇B病毒（CVB）以及乙型和丙型肝炎病毒的病毒基因组。
52例患者中有42例可进行临床随访。42例患者中32例心肌中检测到病毒基因组。在所研究的病毒中，CMV和CVB最为常见。42例患者中有9例达到预定研究终点。病毒基因组的存在与研究终点之间未发现统计学上的显著相关性。所研究的病毒基因组与免疫组织学结果之间未检测到统计学上的显著关系。
DCM患者心肌中病毒基因组的高流行率对其长期临床结局没有影响。
