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A high frequency of viral agents yet absence of Borrelia burgdorferi is seen within the myocardium of subjects with normal left ventricular systolic function: an electron microscopy study

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Abstract

A wide range of viral agents is associated with the development of acute myocarditis and its possible chronic sequela, dilated cardiomyopathy (DCM). There is also increasing evidence that Borrelia burgdorferi (Bb) is associated with DCM in endemic regions for Bb infection. This study sought to use electron microscopy to prospectively analyze the presence of viruses and Bb within the myocardium of 40 subjects with preserved left ventricular (LV) ejection fraction and 40 patients with new-onset unexplained DCM during the same time period. Virus particles were found within the myocardium of 23 subjects (58 %) of both cohorts studied, yet there was no statistically significant difference in virus family presence between those with DCM versus those with preserved LV systolic function. In contrast, Bb was detected only in those subjects with DCM (0 versus 5 subjects; p ˂ 0.05). Polymerase chain reaction was performed on samples from patients who were positive for Bb according to electron microscopy, and Bb was confirmed in 4 out of 5 individuals. Our results demonstrate that the prevalence of viral particles does not differ between subjects with preserved LV systolic function versus those with DCM and therefore suggests that the mere presence of a viral agent within the myocardium is not sufficient to establish a clear link with the development of DCM. In contrast, the presence of Bb was found only within myocardial samples of patients with DCM; this finding supports the idea of a causal relationship between Bb infection and DCM development.

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Funding

The project was supported by PRVOUK-P35/LF1/5, Project reg. no. CZ.2.16/3.1.00/24012 from OP Prague Competitiveness, European Regional Development Fund - Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123) and by The Young Researchers Grant of the Czech Society of Cardiology.

Conflicts of interest

None to declare.

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Authors and Affiliations

  1. 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic

    Petr Kuchynka, Tomas Palecek, Eduard Nemecek, Gabriela Dostalova, Jana Podzimkova & Ales Linhart

  2. International Clinical Research Center, St. Anne’s University Hospital in Brno, Brno, Czech Republic

    Petr Kuchynka & Tomas Palecek

  3. 2nd Department of Surgery, Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic

    Tomas Grus, Vilem Rohn & Jaroslav Lindner

  4. The National Institute of Public Health, Prague, Czech Republic

    Jana Schramlova & Daniel Krsek

  5. Institute of Pathology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic

    Ivana Vitkova

  6. The Heart Hospital, University College London, London, Great Britain

    Eleanor Wicks

Authors
  1. Petr Kuchynka
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  2. Tomas Palecek
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  3. Tomas Grus
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  4. Jana Schramlova
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  8. Jaroslav Lindner
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  9. Eleanor Wicks
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  10. Eduard Nemecek
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  12. Jana Podzimkova
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  13. Ales Linhart
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Corresponding author

Correspondence to Tomas Palecek.

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Kuchynka, P., Palecek, T., Grus, T. et al. A high frequency of viral agents yet absence of Borrelia burgdorferi is seen within the myocardium of subjects with normal left ventricular systolic function: an electron microscopy study. Folia Microbiol 61, 129–135 (2016). https://doi.org/10.1007/s12223-015-0417-8

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  • DOI: https://doi.org/10.1007/s12223-015-0417-8

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