| High prevalence of cardiac parvovirus B19 infection in patients with isolated left ventricular diastolic dysfunction. | |
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MedLine Citation:
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PMID: 15710767 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The etiology of left ventricular (LV) isolated diastolic dysfunction often remains unclear. In the present study, we report a strong association between parvovirus B19 (PVB19) genomes and isolated LV diastolic dysfunction. METHODS AND RESULTS: In 70 patients (mean+/-SD age, 43+/-11 years) admitted with exertional dyspnea and/or reduced exercise tolerance despite preserved LV systolic contractility (ejection fraction=68%), isolated diastolic dysfunction was clinically suspected. Patients with classic risk factors for diastolic dysfunction such as hypertension, coronary heart disease, diabetes mellitus, or pulmonary disease had been excluded. Diastolic function was assessed by echocardiography and LV and RV catheterization. Endomyocardial biopsies (EMBs) were analyzed for the presence of storage or infiltrative diseases or myocarditis, including molecular screening for cardiotropic virus genomes. In a substudy of 24 patients who reported atypical angina, coronary endothelial function was additionally investigated with a coronary Doppler flow-wire technique. In 37 of 70 patients (53%), isolated diastolic dysfunction was confirmed as the cause of their clinical symptoms. No evidence for cardiac storage or infiltrative diseases was found in these cases, but in 35 of 37 of these patients (95%), cardiotropic virus genomes were detected in EMBs (P<0.001). PVB19 was the most frequent pathogen in 31 of 37 patients (84%). In a subgroup of 10 patients with diastolic dysfunction and coexisting endothelial dysfunction, all 10 (100%) were PVB19 positive. CONCLUSIONS: PVB19 genomes were predominant in patients with unexplained, isolated diastolic dysfunction. A strong association with the incidence of endothelial dysfunction was obvious, consistent with the hypothesis that PVB19-induced endothelial dysfunction may be a possible pathomechanism underlying diastolic dysfunction. |
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Authors:
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C Tschöpe; C-T Bock; M Kasner; M Noutsias; D Westermann; P-L Schwimmbeck; M Pauschinger; W-C Poller; U Kühl; R Kandolf; H-P Schultheiss |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2005-02-14 |
Journal Detail:
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Title: Circulation Volume: 111 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2005 Feb |
Date Detail:
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Created Date: 2005-02-22 Completed Date: 2005-10-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 879-86 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology and Pneumology, Charité-University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. ctschoepe@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biopsy Coronary Angiography Diastole* Endothelium / pathology, virology Female Genome, Viral Heart / physiopathology, virology Humans Male Middle Aged Parvoviridae Infections / complications* Parvovirus B19, Human* / genetics Prevalence Ventricular Dysfunction, Left / epidemiology, etiology, virology* |
| Comments/Corrections | |
Comment In:
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Circulation. 2005 Sep 13;112(11):e145; author reply e145
[PMID:
16157779
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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