Abstract 17041: The Role of Mumps Virus in the Etiology of Endomyocardial Fibrosis
Background: Endomyocardial fibrosis (EMF) is the most common worldwide cause of restrictive cardiomyopathy. It is estimated to cause clinically significant disease in over 10,000,000 people residing in sub-tropical, and tropical climates worldwide in the developing world. In our research cohort from a rural area in Mozambique, EMF's prevalence was estimated at 19.8%. Pathologically EMF biopsy and autopsy specimens closely resemble endomyocardial fibroelastosis (EFE), a disease seen in neonates. In previous work there was an association with EFE and mumps virus detected in myocardial autopsy tissue. Additional work has shown a 42% prevalence of cardiotropic viruses (Ebstein-Barr, Coxsackie, etc.) measured by PCR of surgically resected ventricular endomyocardium from EMF patients. Our objective was to determine whether mumps virus plays an etiologic role in EMF, by isolating the virus from surgical resected endomyocardium.
Methods: We analyzed 12 endomyocardial biopsies from previous decortication procedures from patients with end stage EMF. Biopsies were fresh frozen specimens as well as paraffin-blocked samples. Tissue homogenization was done using standard protocols, and RNA extraction and purification was done using the Qiagen RNeasy Micro kit. Standard RT-PCR was done using primers to detect the Mumps' SH gene. Positive controls were mumps virus grown in tissue culture in vero cells. Negative extraction controls were used, as well as non-infected vero cells. Agarose gel electrophoresis was done using the reaction products for confirmation.
Results: There was no detection of mumps viral genome in the 12 EMF biopsy specimens. The positive control reaction products showed the presence of the Mumps' SH gene, and the negative controls showed the absence of Mumps' SH gene.
Conclusion: Very little data exist regarding the pathogenesis of EMF. Mumps virus was a logical targeted potential agent, with its causal relationship in EFE clearly shown. Our data certainly suggest that no such relationship exists with EMF.
- © 2010 by American Heart Association, Inc.