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Heart 2001;86:687-692; doi:10.1136/heart.86.6.687
Copyright © 2001 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2001;86:687-692 ( December )

Basic research

Absence of viral nucleic acids in early and late dilated cardiomyopathy N G Mahon* a, B Zal* a, G Arnoa, P Risleya, J Pinto-Bastob, W J McKennaa, M J Daviesa, C Babooniana

a Department of Cardiological Sciences, St George's Hospital Medical School, London SW17 0RE, UK, b Department of Medical Microbiology, St George's Hospital Medical School

Correspondence to: Dr Baboonian cbabooni{at}sghms.ac.uk

Accepted 22 August 2001

OBJECTIVE---To investigate whether viral infection acts as a trigger factor for the development of dilated cardiomyopathy in genetically predisposed individuals with a family history of disease.
SETTING---Patients attending the cardiomyopathy unit in a cardiac tertiary referral centre.
DESIGN---Nested polymerase chain reaction (nPCR) was used to determine whether enteroviral, adenoviral, or cytomegaloviral nucleic acids were detectable in the myocardium of 19 asymptomatic relatives of patients with dilated cardiomyopathy; all these relatives had echocardiographic abnormalities thought to represent early disease. Explanted hearts from patients with end stage dilated cardiomyopathy were also studied and were compared with 25 controls (ischaemic heart disease (21), valvar heart disease (2), hypertrophic cardiomyopathy (1), restrictive cardiomyopathy (1)). Myocardial tissue from two fatal cases of culture positive coxsackie myocarditis was used as a positive control.
RESULTS---No viral nucleic acid was detected in any group other than in those with myocarditis. Spiking of random wells with purified recombinant viral nucleic acids confirmed the sensitivity and reproducibility of the assays.
CONCLUSIONS---Myocardial viral infection is not detectable in relatives of patients with dilated cardiomyopathy who are suspected of having early disease. There is no evidence that viruses act as a trigger factor for initiating the dilated cardiomyopathy in these patients.


Keywords: viral infection; dilated cardiomyopathy

* N G Mahon and B Zal contributed equally to this work

© 2001 by Heart
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