Prevalence of hepatitis C and B virus infection in patients with idiopathic dilated cardiomyopathy in Brazil: a pilot study

The idiopathic dilated cardiomyopathy (IDMC) is a disease of the cardiac muscle characterized by systolic dilation and/or dysfunction of one or both ventricles, symptoms of congestive heart failure and risk of early death. Several studies in animal models and in humans have supported the hypothesis of the viral infection as initial event in the immunopathogenesis of the ventricular dilation. The objective of this study was to correlate the presence of hepatitis C virus chronic infection and idiopathic dilated cardiomyopathy, comparing samples of cases with IDCM with paired controls with Chagas-type specific dilated cardiomyopathy and ischemic-type specific dilated cardiomyopathy. Only 2.9 percent (1/34) of IDCM patients were HCV carriers, which strongly argue against this hypothesis. Therefore, based on our results, there is no justification for investigating HCV in patients with idiopathic dilated cardiomyopathy diagnosis.

The expression of coxsackie B virus adenovirus receptor (CAR) in viral myocarditis and dilated cardiomyopathy patients / 法医学杂志

OBJECTIVE@#To explore etiology and pathogenesis of viral myocarditis (VMC) and dilated cardiomyopathy (DCM).@*METHODS@#The expression of Coxsackie B virus and adenovirus receptors (CAR) were detected with modified immunohistochemical (IHC) technique in myocardium of left ventricle, right ventricle, interventricular septum, and septal papillary muscle from 28 patients with viral myocarditis, 31 patients with dilated cardiomyopathy and 17 control patients (including normal, hypertension heart disease, myocardial infarction and coronary atherosclerotic heart disease).@*RESULTS@#The brown staining on the cell membrane of myocardium represents positive result. 100% (28 of 28) of VMC patients (IHC surface integral: 4.3975 +/- 0.0365) and 84% (26 of 31) of DCM patients (4.2064 +/- 0.052 6) had prevalent CAR expression compared to 0% (0 of 19) control patients (0.073 1 +/- 0.0362). There were statistically significant differences between VMC/DCM and control patients (P < 0.05).@*CONCLUSION@#The prevalence of CAR expression was significantly higher in VMC and DCM patients (100% and 84% vs. 0% in control). In contrast, there was no difference found between VMC and DCM patients. These results suggest that both VMC and DCM involve viral etiology and could share a similar pathogenesis.

Is hepatitis C virus a cause of idiopathic dilated cardiomyopathy?: a systematic review of literature

Recent studies have suggested that some patients with idiopathic dilated cardiomyopathy (IDC) are also afflicted with insidious forms of viral myocarditis. Participation of hepatitis C virus (HCV) in this process has been postulated. The objective of this study was to evaluate a possible association between hepatitis C virus and idiopathic dilated cardiomyopathy. Systematic review of the literature using electronic databases (MEDLINE, EMBASES, LILACS and COCHRANE) for the period from 1995 to 2005, limited to papers published in English, Spanish and Portuguese. Sixty-two papers were found, of which six were in accordance with the proposed methodology. After selection, the articles were classified by quality of data and number of variables studied. Most of the patients were male adults from 31 and 75 years old, who had ischemic cardiopathy excluded as etiology of the dilated cardiomyopathy. A significant association between dilated cardiomyopathy and hepatitis C virus was found in only two papers, both from Japan and by the same author. Most of the papers received low classifications, as they did not fulfill the systematization criteria.

Enteroviruses as a possible cause of myocarditis, pericarditis and dilated cardiomyopathy in Belém, Brazil

We attempted to assess the role of enteroviruses in the etiology of myocarditis (MC), pericarditis (PC) and dilated cardiomyopathy (DCM) among 15 in-patients at a public hospital in Belém, Brazil, from November 1992 to December 1993. We obtained stool specimens and throat swabs from each patient (particularly acute cases) and, when possible, acute and convalescent serum samples for both isolation and serological procedures. MC, PC and DCM ocurred in 10, 2 and 3 patients, respectively, mostly in the 0- to 10- year age group. Neutralizing antibody seroconversions were detected as follows: one for Coxsackievirus (Cox) B2 in one patient suffering from MC, and two for Cox B4, in patients with DCM and MC. In addition, antibody titers of 1/320 against Cox B2 and Cox B4 were noted in two other patients, one suffering from PC and the other presenting MC. Isolation of echovirus (ECHO) serotype 1 was recorded ina a patient with MC, without either seroconversion or high antibody levels for Cox B 1 to 6. These results indicate that enteroviruses may be involved in the etiology of MC, PC and DCM in the Amazon region.