BACKGROUND: Transplantation has become a lifesaving procedure for children with end-stage heart failure. The long-term outcome for children who undergo transplantation has been of considerable interest, but the causes of graft failure and death are largely unknown, and the role of pre-transplant viral infection is unclear. METHODS: Myocardial samples from 80 explanted hearts from children with end-stage heart disease caused by congenital heart disease (CHD), cardiomyopathy, or chronic rejection were analyzed using polymerase chain reaction and reverse-transcriptase polymerase chain reaction for cardiotropic viruses using virus-specific primers. We used immunohistochemical analysis of cytoskeletal proteins to evaluate myocyte architecture. RESULTS: We identified parvoviral genomes in 6 patients (3 with CHD and 3 with cardiomyopathy). We detected no other viruses. Immunohistochemistry showed normal staining for key components of the cytoskeleton/sarcolemma, sarcomere, and nuclear membrane in the 6 virus-positive samples. The clinical outcome of these children was worse (4 long-term survivors, but 2 deaths) than for individuals without the genome. CONCLUSIONS: Detecting viruses within the myocardium at the point of end-stage heart failure is not common, regardless of the primary pathology. However, the presence of viruses may result in poor outcome for the patient.
BACKGROUND: Transplantation has become a lifesaving procedure for children with end-stage heart failure. The long-term outcome for children who undergo transplantation has been of considerable interest, but the causes of graft failure and death are largely unknown, and the role of pre-transplant viral infection is unclear. METHODS: Myocardial samples from 80 explanted hearts from children with end-stage heart disease caused by congenital heart disease (CHD), cardiomyopathy, or chronic rejection were analyzed using polymerase chain reaction and reverse-transcriptase polymerase chain reaction for cardiotropic viruses using virus-specific primers. We used immunohistochemical analysis of cytoskeletal proteins to evaluate myocyte architecture. RESULTS: We identified parvoviral genomes in 6 patients (3 with CHD and 3 with cardiomyopathy). We detected no other viruses. Immunohistochemistry showed normal staining for key components of the cytoskeleton/sarcolemma, sarcomere, and nuclear membrane in the 6 virus-positive samples. The clinical outcome of these children was worse (4 long-term survivors, but 2 deaths) than for individuals without the genome. CONCLUSIONS: Detecting viruses within the myocardium at the point of end-stage heart failure is not common, regardless of the primary pathology. However, the presence of viruses may result in poor outcome for the patient.
Authors: John P Breinholt; Mousumi Moulik; William J Dreyer; Susan W Denfield; Jeffrey J Kim; John L Jefferies; Joseph W Rossano; Corey M Gates; Sarah K Clunie; Karla R Bowles; Debra L Kearney; Neil E Bowles; Jeffrey A Towbin Journal: J Heart Lung Transplant Date: 2010-04-24 Impact factor: 10.247
Authors: Garrick C Stewart; Javier Lopez-Molina; Raju V S R K Gottumukkala; Gregg F Rosner; Mary S Anello; Jonathan L Hecht; Gayle L Winters; Robert F Padera; Kenneth L Baughman; Myra A Lipes Journal: Circ Heart Fail Date: 2010-11-19 Impact factor: 8.790
Authors: Biagio A Pietra; Paul F Kantor; Heather L Bartlett; Clifford Chin; Charles E Canter; Ranae L Larsen; R Erik Edens; Steven D Colan; Jeffrey A Towbin; Steven E Lipshultz; James K Kirklin; David C Naftel; Daphne T Hsu Journal: Circulation Date: 2012-07-16 Impact factor: 29.690
Authors: Eniko Tátrai; István Hartyánszky; András Lászik; György Acsády; Péter Sótonyi; Márta Hubay Journal: Pathol Oncol Res Date: 2010-09-18 Impact factor: 3.201