Document Detail

Detection of Chlamydia pneumoniae in human nonrheumatic stenotic aortic valves.
MedLine Citation:
PMID:  9120159     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to study the possible presence of Chlamydia pneumoniae in aortic valve stenosis (AVS). BACKGROUND: Inflammation and immune mechanisms are considered important for the pathogenesis of nonrheumatic AVS. All chlamydial species are able to cause heart infections, and seroepidemiologic studies have indicated an association between chronic C. pneumoniae infection and coronary artery disease. Furthermore, the organism has been demonstrated in atherosclerotic lesions. METHODS: Aortic valve specimens with varying degrees of macroscopic disease were obtained from 35 subjects--17 consecutive patients undergoing aortic valve replacement for treatment of nonrheumatic AVS and 18 age-matched subjects at autopsy. The possible presence of C. pneumoniae in aortic valves was studied by immunohistochemical analysis, polymerase chain reaction or transmission electron microscopy, or a combination of these. RESULTS: Positive immunohistochemical staining with C. pneumoniae specific antibody was found in 9 (53%) of 17 patients with advanced aortic valve disease requiring surgical treatment (group A), 8 (80%) of 10 cadavers with clearly macroscopic aortic valve pathology (group B) and 1 (12%) of 8 grossly normal cadaver control subjects (group C). Statistical significance with regard to the presence of C. pneumoniae was found when combined diseased subjects (groups A and B: total 17 of 27 subjects) were compared with group C (p = 0.018). However, when group A was compared with group C, there was only marginal statistical significance (p = 0.088). Finally, there was a strong statistical significance (p = 0.015) when groups B and C were compared. Chlamydia pneumoniae DNA was also found in three stenotic valves, and in two of the three tested valve specimens chlamydia-like particles were seen by electron microscopy. CONCLUSIONS: Chlamydia pneumoniae is frequently present in nonrheumatic AVS. Similarly, the high number of C. pneumoniae infections detected in the early lesions of "degenerative" AVS suggest that this pathogen may play an etiologic role in the development of this disease. The validity of this relation requires additional study.
J Juvonen; A Laurila; T Juvonen; H Aläkarppä; H M Surcel; K Lounatmaa; J Kuusisto; P Saikku
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  29     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-04-24     Completed Date:  1997-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1054-9     Citation Subset:  AIM; IM    
National Public Health Institute, Oulu, Finland.
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MeSH Terms
Aortic Valve / microbiology
Aortic Valve Stenosis / microbiology*,  pathology
Chlamydia Infections / complications*,  pathology
Chlamydophila pneumoniae / isolation & purification*
DNA, Bacterial / analysis
Endocarditis, Bacterial / complications*,  pathology
Microscopy, Electron
Middle Aged
Polymerase Chain Reaction
Reg. No./Substance:
0/DNA, Bacterial

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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