Pathology & Oncology Research

, Volume 17, Issue 2, pp 229–235 | Cite as

The Role of Viral Infections in the Development of Dilated Cardiomyopathy

  • Enikő TátraiEmail author
  • István HartyánszkyJr.
  • András Lászik
  • György Acsády
  • Péter Sótonyi
  • Márta Hubay


Enteroviruses (EVs) are the most frequent pathogens in myocarditis and in the subsequently developing dilated cardiomyopathy as well. Furthermore, persistence of other viruses might play a pathogenic role in the evolution from myocarditis to dilated cardiomyopathy. Explanted heart of 28 patients, who underwent heart transplantation were screened for EV, AdV3 and HHV6 sequences in order to assess the incidence of cardiac viral infection that may be implicated in the pathogenesis of cardiomyopathy, and estimate viral distribution in the myocardium. Viral sequences were extracted from five different regions of the hearts. Nested PCR was used to amplify conservative regions of AdV3, HHV6 and EVs. Histological examination was performed on routinely processed myocardial samples. AdV3 was verified in one fourth of the patients. ADV3 and HHV6 sequences coexisted in one case with inflammatory cardiomyopathy. Some patients had more than one positive area of their heart. AdV3 positive right ventricular samples were double in amount compared to the left ones. None of the patients had positive result for EV. This is the first occasion to identify AdV3 (a mainly respiratory infective virus) sequence in explanted hearts of cardiomyopathy patients. Though the clinical importance of our results is still unclear, AdV3 could be a new member of the viral group with possible pathogenic effect on the myocardium. Regional distribution of viral sequence location confirmed that the right ventricular wall as a biopsy sampling site might be adequate for endomyocardial biopsy pro diagnostic purposes.


Cardiomyopathy Endomyocardial biopsy Myocardium Polymerase chain reaction Viruses 



Adenovirus type 2


Adenovirus type 3


Adenovirus type 5




Dilated cardiomyopathy


Deoxyribonucleic acid


Endomyocardial biopsy




Human Herpes Virus type 6




National Centre for Biotechnology Information


negative result


Polymerase chain reaction


Phosphotungstic acid-haematoxylin


Parvovirus B19


Ribonucleic acid


World Health Organization



This study was supported by grant No. ETT 165/2006. We express our gratitude to Ilona Kovalszky and Katalin Bedi at the 1st Institute of Pathology and Experimental Cancer Research, Semmelweis University, Budapest.


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Copyright information

© Arányi Lajos Foundation 2010

Authors and Affiliations

  • Enikő Tátrai
    • 1
    Email author
  • István HartyánszkyJr.
    • 2
  • András Lászik
    • 1
  • György Acsády
    • 2
  • Péter Sótonyi
    • 1
  • Márta Hubay
    • 1
  1. 1.Department of Forensic & Insurance MedicineSemmelweis UniversityBudapestHungary
  2. 2.Vascular- and Cardiac Surgery ClinicSemmelweis UniversityBudapestHungary

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