Circulation, Vol 82, 8-16, Copyright © 1990 by American Heart Association
O Jin, MJ Sole, JW Butany, WK Chia, PR McLaughlin, P Liu and CC Liew
Recent molecular studies have suggested that viral myocarditis frequently
underlies human congestive cardiomyopathy; however, only moderately
sensitive and specific techniques were used. Polymerase chain reaction
(PCR) gene amplification is a sensitive, specific technique ideally suited
for the diagnosis of viral disease in small tissue samples where low copy
numbers of the viral genome may be present. Using PCR and high stringency
condition, we screened biopsies taken from 48 patients with clinically
suspected myocarditis or dilated cardiomyopathy. Five patients demonstrated
positive enteroviral signals by PCR; two of them had myocarditis by
pathology, whereas the other three had changes consistent with
cardiomyopathy. Four other patients had myocarditis diagnosed by pathology
from 3 months to 1 year earlier but were now negative by both PCR and
pathology. Both pathology and PCR were negative for active myocarditis in
all other patients. Ventricular samples taken from left ventricular
myectomy in four additional patients with hypertrophic cardiomyopathy,
normal human ventricle samples, and uninfected monkey kidney cells were
also negative by PCR. This study supports a link between viral infection
and dilated cardiomyopathy in some patients. PCR gene amplification
provides a new diagnostic approach to patients with suspected myocarditis.
ARTICLES
Detection of enterovirus RNA in myocardial biopsies from patients with myocarditis and cardiomyopathy using gene amplification by polymerase chain reaction
Department of Medicine, University of Toronto, Ontario, Canada.
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