Document Detail


Prevalence and prognostic implications of active cytomegalovirus infection in patients with acute heart failure.
MedLine Citation:
PMID:  20575763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AHF (acute heart failure) causes significant morbidity and mortality. Recent studies have postulated that the expression of inflammatory mediators, such as cytokines and chemokines, plays an important role in the development and progression of heart failure. A pro-inflammatory state has been postulated as a key factor in triggering CMV (cytomegalovirus) reactivation. Therefore we sought to determine the prevalence of active CMV infection in immunocompetent patients admitted for AHF and to quantify the association with the risk of the combined end point of death or AHF readmission. A total of 132 consecutive patients admitted for AHF were enrolled in the present study. Plasma CMV DNAaemia was assessed by qRT-PCR (quantitative real-time PCR), and cytokine measurements in plasma were performed by ELISA. Clinical data were evaluated by personnel blinded to CMV results. The independent association between active CMV infection and the end point was determined by Cox regression analysis. During a median follow-up of 120 [IQR (interquartile range), 60-240] days, 23 (17.4%) deaths, 34 (24.2%) readmissions for AHF and 45 (34.1%) deaths/readmissions for AHF were identified. Plasma CMV DNAaemia occurred in 11 (8.3%) patients, albeit at a low level (<100 copies/ml). The cumulative rate of the composite end point was higher in patients with CMV DNAaemia (81.8 compared with 29.8%; P<0.001). After adjusting for established risk factors, the occurrence of CMV DNAaemia was strongly associated with the clinical end point [hazard ratio = 4.39 (95% confidence interval, 2.02-9.52); P<0.001]. In conclusion, active CMV infection occurs, although uncommonly, in patients with AHF, and may be a marker of disease severity.
Authors:
Julio Núñez; Marifina Chilet; Juan Sanchis; Vicent Bodí; Eduardo Núñez; Gema Miñana; Nuria Tormo; Maria A Clari; Mauricio Pellicer; Francisco J Chorro; Angel Llàcer; David Navarro
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-05
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  119     ISSN:  1470-8736     ISO Abbreviation:  Clin. Sci.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-08-05     Completed Date:  2010-11-23     Revised Date:  2011-05-25    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  443-52     Citation Subset:  IM    
Affiliation:
Cardiology Service, Hospital Clínico Universitario, INCLIVA, Blasco Ibañez 17, Valencia, Spain. yulnunez@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Cytokines / blood
Cytomegalovirus / genetics,  isolation & purification,  physiology*
Cytomegalovirus Infections / blood,  complications*
DNA, Viral / blood
Epidemiologic Methods
Female
Heart Failure / blood,  complications*
Humans
Inflammation Mediators / blood
Length of Stay
Male
Middle Aged
Patient Readmission / statistics & numerical data
Prognosis
Virus Activation
Chemical
Reg. No./Substance:
0/Cytokines; 0/DNA, Viral; 0/Inflammation Mediators

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