| Parvovirus B19 infection mimicking acute myocardial infarction. | |
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MedLine Citation:
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PMID: 12925460 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Enteroviruses (EVs) and adenoviruses (ADVs) have been considered common causes of myocarditis and dilated cardiomyopathy. In the present study, we report on the association of parvovirus B19 (PVB19) genomes in the clinical setting of acute myocarditis. METHODS AND RESULTS: This study included 24 consecutive patients admitted to our hospital within 24 hours after onset of chest pain. Acute myocardial infarction had been excluded in all patients by coronary angiography. Endomyocardial biopsies were analyzed by nested polymerase chain reaction/reverse transcriptase-polymerase chain reaction for EV, ADV, PVB19, human cytomegalovirus, Epstein-Barr virus, Chlamydia pneumoniae, influenza virus A and B, and Borrelia burgdorferi genomes, respectively, followed by direct sequencing of the amplification products. All patients presented with acute onset of angina pectoris and ST-segment elevations or T-wave inversion mimicking acute myocardial infarction. Mean baseline peak creatinine kinase and creatine kinase-isoenzyme fraction were 342+/-241 U/L and 32+/-20 U/L, respectively. Mean troponin T was increased to 7.5+/-15.0 ng/mL and C-reactive protein to 91+/-98 mg/mL. Eighteen patients had global or regional wall motion abnormalities (ejection fraction 62.5+/-15.5%). Histological analysis excluded the presence of active or borderline myocarditis in all but one patient. PVB19, EV, and ADV genomes were detected in the myocardium of 12, 3, and 2 patients, respectively (71%). Follow-up biopsies of virus-positive patients (11 of 17) demonstrated persistence of PVB19 genomes in 6 of 6 patients, EV genomes in 2 of 3 patients, and ADV genomes in 1 of 2 patients, respectively. CONCLUSIONS: Virus genomes can be demonstrated in 71% of patients with normal coronary anatomy, clinically mimicking acute myocardial infarction. In addition to EVs and ADVs, PVB19 was the most frequent pathogen. |
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Authors:
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Uwe Kühl; Matthias Pauschinger; Thomas Bock; Karin Klingel; C Peter Lothar Schwimmbeck; Bettina Seeberg; Lars Krautwurm; Wolfgang Poller; Heinz-Peter Schultheiss; Reinhard Kandolf |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2003-08-18 |
Journal Detail:
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Title: Circulation Volume: 108 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Aug |
Date Detail:
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Created Date: 2003-08-26 Completed Date: 2003-09-23 Revised Date: 2004-11-17 |
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: 945-50 Citation Subset: AIM; IM |
Affiliation:
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Medical Clinic II, Department of Cardiology, University Hospital Benjamin Franklin, Berlin, Germany. dcmkuehl@zedat.fu-berlin.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adolescent Adult Aged Angina Pectoris / etiology Biopsy Chest Pain / etiology Coronary Angiography DNA, Viral / analysis, genetics Diagnosis, Differential Echocardiography Electrocardiography Female Follow-Up Studies Heart / virology Humans Immunohistochemistry Male Middle Aged Myocardial Infarction / complications, diagnosis*, virology Myocarditis / complications, diagnosis*, virology Myocardium / pathology Parvoviridae Infections / complications, diagnosis*, virology Parvovirus B19, Human / genetics, isolation & purification* Polymerase Chain Reaction Recurrence Viruses / genetics, isolation & purification* |
| Chemical | |
Reg. No./Substance:
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0/DNA, Viral |
| Comments/Corrections | |
Comment In:
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Circulation. 2004 Apr 13;109(14):e179
[PMID:
15078808
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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