The presence and type of viral genomes have been suggested as the main etiology forinflammatory dilated cardiomyopathy. Information on the clinical implication of this finding ina large population of children is lacking. We evaluated the prevalence, type, and clinical impact ofspecific viral genomes in endomyocardial biopsies (EMB) collected between 2001 and 2013 among63 children admitted to our hospital for acute heart failure (median age 2.8 years). Viral genomewas searched by polymerase chain reaction (PCR). Patients underwent a complete two-dimensionalechocardiographic examination at hospital admission and at discharge and were followed-up for10 years. Twenty-seven adverse events (7 deaths and 20 cardiac transplantations) occurred duringthe follow-up. Viral genome was amplified in 19/63 biopsies (35%); PVB19 was the most commonlyisolated virus. Presence of specific viral genome was associated with a significant recovery inejection fraction, compared to patients without viral evidence (p < 0.05). In Cox-regression analysis,higher survival rate was related to virus-positive biopsies (p < 0.05). When comparing long-termprognosis among different viral groups, a trend towards better prognosis was observed in thepresence of isolated Parvovirus B19 (PVB19) (p = 0.07). In our series, presence of a virus-positiveEMB (mainly PVB19) was associated with improvement over time in cardiac function and betterlong-term prognosis.
The impact of specific viruses on clinical outcome in children presenting with acute heart failure
Fierabracci A;
2016-01-01
Abstract
The presence and type of viral genomes have been suggested as the main etiology forinflammatory dilated cardiomyopathy. Information on the clinical implication of this finding ina large population of children is lacking. We evaluated the prevalence, type, and clinical impact ofspecific viral genomes in endomyocardial biopsies (EMB) collected between 2001 and 2013 among63 children admitted to our hospital for acute heart failure (median age 2.8 years). Viral genomewas searched by polymerase chain reaction (PCR). Patients underwent a complete two-dimensionalechocardiographic examination at hospital admission and at discharge and were followed-up for10 years. Twenty-seven adverse events (7 deaths and 20 cardiac transplantations) occurred duringthe follow-up. Viral genome was amplified in 19/63 biopsies (35%); PVB19 was the most commonlyisolated virus. Presence of specific viral genome was associated with a significant recovery inejection fraction, compared to patients without viral evidence (p < 0.05). In Cox-regression analysis,higher survival rate was related to virus-positive biopsies (p < 0.05). When comparing long-termprognosis among different viral groups, a trend towards better prognosis was observed in thepresence of isolated Parvovirus B19 (PVB19) (p = 0.07). In our series, presence of a virus-positiveEMB (mainly PVB19) was associated with improvement over time in cardiac function and betterlong-term prognosis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
