Detection of viruses in myocardial tissues by polymerase chain reaction

Evidence of adenovirus as a common cause of myocarditis in children and adults

Neil E. Bowles, Jiyuan Ni, Debra L. Kearney, Matthias Pauschinger, Heinz Peter Schultheiss, Robert McCarthy, Joshua Hare, J. Timothy Bricker, Karla R. Bowles, Jeffrey A. Towbin

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The purpose of this study was to analyze cardiac tissue and blood for viral genomes using polymerase chain reaction (PCR) to define the common viral etiologies of myocarditis by age group. BACKGROUND: Enteroviruses are considered the most common cause of myocarditis at all ages. Diagnosis relies on viral cultures, serology, and cardiac histology, which lack sensitivity, as well as PCR. However, in many cases enteroviruses are not detected. METHODS: Cardiac samples were obtained for PCR analysis from patients with myocarditis (n = 624) and dilated cardiomyopathy (DCM) (n = 149). Patients were analyzed by age group, including neonates (n = 116), infants (n = 191), toddlers (n = 87), children (n = 110), adolescents (n = 92), and adults (n = 177). After nucleic acids had been extracted from an endomyocardial biopsy, an explant, or autopsy samples, PCR and reverse transcription PCR were performed to detect the genomic sequences of enterovirus, adenovirus, cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV), parvovirus, respiratory syncytial virus (RSV), and influenza A virus. RESULTS: Viral genome was amplified (adenovirus = 142, enterovirus = 85, CMV = 18, parvovirus = 6, influenza A = 5, HSV = 5, EBV = 3, RSV = 1) from 239 (38%) of the 624 samples from myocarditis patients, including 26 patient samples in which dual infection was found. Virus was detected in 30 (20%) of 149 DCM patient samples; only adenovirus (n = 18) and enterovirus (n = 12) were detected. CONCLUSIONS: Polymerase chain reaction identified adenovirus as the most common virus in the myocardium of children and adults with myocarditis and DCM. Although enteroviruses are also found in these patients, they appear to be a less common cause of myocarditis than adenovirus.

Original languageEnglish (US)
Pages (from-to)466-472
Number of pages7
JournalJournal of the American College of Cardiology
Volume42
Issue number3
DOIs
StatePublished - Aug 6 2003

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Enterovirus
Myocarditis
Adenoviridae
Viruses
Polymerase Chain Reaction
Dilated Cardiomyopathy
Parvovirus
Respiratory Syncytial Viruses
Viral Genome
Simplexvirus
Cytomegalovirus
Human Herpesvirus 4
Age Groups
Influenza A virus
Serology
Nucleic Acids
Human Influenza
Reverse Transcription
Autopsy
Myocardium

ASJC Scopus subject areas

  • Nursing(all)

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Detection of viruses in myocardial tissues by polymerase chain reaction : Evidence of adenovirus as a common cause of myocarditis in children and adults. / Bowles, Neil E.; Ni, Jiyuan; Kearney, Debra L.; Pauschinger, Matthias; Schultheiss, Heinz Peter; McCarthy, Robert; Hare, Joshua; Bricker, J. Timothy; Bowles, Karla R.; Towbin, Jeffrey A.

In: Journal of the American College of Cardiology, Vol. 42, No. 3, 06.08.2003, p. 466-472.

Research output: Contribution to journalArticle

Bowles, NE, Ni, J, Kearney, DL, Pauschinger, M, Schultheiss, HP, McCarthy, R, Hare, J, Bricker, JT, Bowles, KR & Towbin, JA 2003, 'Detection of viruses in myocardial tissues by polymerase chain reaction: Evidence of adenovirus as a common cause of myocarditis in children and adults', Journal of the American College of Cardiology, vol. 42, no. 3, pp. 466-472. https://doi.org/10.1016/S0735-1097(03)00648-X
Bowles, Neil E. ; Ni, Jiyuan ; Kearney, Debra L. ; Pauschinger, Matthias ; Schultheiss, Heinz Peter ; McCarthy, Robert ; Hare, Joshua ; Bricker, J. Timothy ; Bowles, Karla R. ; Towbin, Jeffrey A. / Detection of viruses in myocardial tissues by polymerase chain reaction : Evidence of adenovirus as a common cause of myocarditis in children and adults. In: Journal of the American College of Cardiology. 2003 ; Vol. 42, No. 3. pp. 466-472.
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abstract = "OBJECTIVES: The purpose of this study was to analyze cardiac tissue and blood for viral genomes using polymerase chain reaction (PCR) to define the common viral etiologies of myocarditis by age group. BACKGROUND: Enteroviruses are considered the most common cause of myocarditis at all ages. Diagnosis relies on viral cultures, serology, and cardiac histology, which lack sensitivity, as well as PCR. However, in many cases enteroviruses are not detected. METHODS: Cardiac samples were obtained for PCR analysis from patients with myocarditis (n = 624) and dilated cardiomyopathy (DCM) (n = 149). Patients were analyzed by age group, including neonates (n = 116), infants (n = 191), toddlers (n = 87), children (n = 110), adolescents (n = 92), and adults (n = 177). After nucleic acids had been extracted from an endomyocardial biopsy, an explant, or autopsy samples, PCR and reverse transcription PCR were performed to detect the genomic sequences of enterovirus, adenovirus, cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV), parvovirus, respiratory syncytial virus (RSV), and influenza A virus. RESULTS: Viral genome was amplified (adenovirus = 142, enterovirus = 85, CMV = 18, parvovirus = 6, influenza A = 5, HSV = 5, EBV = 3, RSV = 1) from 239 (38{\%}) of the 624 samples from myocarditis patients, including 26 patient samples in which dual infection was found. Virus was detected in 30 (20{\%}) of 149 DCM patient samples; only adenovirus (n = 18) and enterovirus (n = 12) were detected. CONCLUSIONS: Polymerase chain reaction identified adenovirus as the most common virus in the myocardium of children and adults with myocarditis and DCM. Although enteroviruses are also found in these patients, they appear to be a less common cause of myocarditis than adenovirus.",
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AU - Ni, Jiyuan

AU - Kearney, Debra L.

AU - Pauschinger, Matthias

AU - Schultheiss, Heinz Peter

AU - McCarthy, Robert

AU - Hare, Joshua

AU - Bricker, J. Timothy

AU - Bowles, Karla R.

AU - Towbin, Jeffrey A.

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