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Suspected inflammatory cardiomyopathy

Prevalence of Borrelia burgdorferi in endomyocardial biopsies with positive serological evidence

Verdacht auf entzündliche Kardiomyopathie

Prävalenz von Borrelia burgdorferi in Endomyokardbiopsien bei positiver Borrelienserologie

Herz volume 40, pages 91–95 (2015)Cite this article

Abstract

Background

Cardiac involvement in Lyme disease, caused by the tick-borne spirochete Borrelia burgdorferi, has been reported to occur in 0.3–4 % of infected patients in Europe. Cardiac manifestations may include conduction disturbances, and also myocarditis, pericarditis, and left ventricular dysfunction. We investigated the prevalence of B. burgdorferi DNA in endomyocardial biopsies from patients with suspected inflammatory heart disease and positive serology for B. burgdorferi.

Methods and results

In 64 patients, endomyocardial biopsies were taken after exclusion of coronary heart disease by coronary angiography, and investigated with polymerase chain reaction (PCR) for the presence of B. burgdorferi and cardiotropic viruses. B. burgdorferi DNA was not detected in any of the endomyocardial biopsies. Viruses, particularly parvovirus B19, were detected as infectious agents in 19 (30 %) patients.

Conclusion

The results of our study demonstrate that PCR analysis of endomyocardial biopsies from patients with suspected inflammatory heart disease, including individuals with dilated cardiomyopathy (DCM) and positive serology for B. burgdorferi, did not reveal the B. burgdorferi genome in any biopsy sample.

Zusammenfassung

Hintergrund

Eine kardiale Beteiligung im Rahmen der Lyme-Borreliose, die mittels Zeckenübertragung von Spirochäten der Gattung Borrelia burgdorferi verursacht wird, ist in Europa in 0,3–4 % der Fälle zu beobachten. Zu den kardialen Manifestationsformen gehören Reizleitungsstörungen, Perikarditis, Myokarditis und linksventrikuläre Funktionsstörungen. Ziel dieser Arbeit war die Untersuchung der Prävalenz von Borrelien-DNA in Endomyokardbiopsaten von Patienten mit Verdacht auf entzündliche Kardiomyopathie und mit positiver Borrelienserologie.

Methoden

Nach koronarangiographischem Ausschluss einer koronaren Herzkrankheit wurden die Endomyokardbiopsien von 64 Patienten mit PCR auf das Vorliegen von Borrelia burgdorferi und kardiotrope Viren untersucht. In keinem der Endomyokardbiopsate ließ sich Borrelien-DNA nachweisen. Kardiotrope Viren, insbesondere Parvovirus B19, konnte dagegen bei 19 Patienten (30 % der Fälle) nachgewiesen werden.

Schlussfolgerung

Den Ergebnissen der vorliegenden Studie zufolge ergab die PCR-Untersuchung der Endomyokardbiopsien von Patienten mit Verdacht auf eine entzündliche Herzerkrankung einschließlich dilatativer Kardiomyopathie und mit positiver Borrelienserologie keinen Nachweis von Borrelien-DNA.

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Compliance with ethical guidelines

Conflict of interest. K. Karatolios, B. Maisch, and S. Pankuweit state that there are no conflicts of interest. The accompanying manuscript does not include studies on humans or animals.

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Authors and Affiliations

  1. Department of Internal Medicine-Cardiology, Philipps-University Marburg, Baldingerstr., 35033, Marburg, Deutschland

    K. Karatolios MD, B. Maisch & S. Pankuweit

Authors
  1. K. Karatolios MD
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  2. B. Maisch
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  3. S. Pankuweit
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Correspondence to K. Karatolios MD.

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Karatolios, K., Maisch, B. & Pankuweit, S. Suspected inflammatory cardiomyopathy. Herz 40 (Suppl 1), 91–95 (2015). https://doi.org/10.1007/s00059-014-4118-x

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  • DOI: https://doi.org/10.1007/s00059-014-4118-x

Keywords

  • Lyme borreliosis
  • Borrelia burgdorferi
  • Dilated cardiomyopathy
  • Molecular biology
  • Polymerase chain reaction

Schlüsselwörter

  • Lyme-Borreliose
  • Borrelia burgdorferi
  • Dilatative Kardiomyopathie
  • Molekularbiologie
  • Polymerasekettenreaktion