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Int. J. Mol. Sci. 2016, 17(4), 486; doi:10.3390/ijms17040486

The Impact of Specific Viruses on Clinical Outcome in Children Presenting with Acute Heart Failure

1
Medical and Surgical Department of Cardiology, Children’s Hospital Bambino Gesù, Piazza S. Onofrio 4, 00165 Rome, Italy
2
Immuno-Infectivology and Clinical Trials Area, Children’s Hospital Bambino Gesù, Viale S. Paolo 15, 00146 Rome, Italy
3
Operative Unit and Chair of Cardiac Surgery, Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy
4
Department of Laboratory Medicine, Children’s Hospital Bambino Gesù, Piazza S. Onofrio 4, 00165 Rome, Italy
5
Department of Pathology, Children’s Hospital Bambino Gesù, Piazza S. Onofrio 4, 00165 Rome, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Susanna Esposito
Received: 29 January 2016 / Revised: 14 March 2016 / Accepted: 28 March 2016 / Published: 1 April 2016
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Abstract

The presence and type of viral genomes have been suggested as the main etiology for inflammatory dilated cardiomyopathy. Information on the clinical implication of this finding in a large population of children is lacking. We evaluated the prevalence, type, and clinical impact of specific viral genomes in endomyocardial biopsies (EMB) collected between 2001 and 2013 among 63 children admitted to our hospital for acute heart failure (median age 2.8 years). Viral genome was searched by polymerase chain reaction (PCR). Patients underwent a complete two-dimensional echocardiographic examination at hospital admission and at discharge and were followed-up for 10 years. Twenty-seven adverse events (7 deaths and 20 cardiac transplantations) occurred during the follow-up. Viral genome was amplified in 19/63 biopsies (35%); PVB19 was the most commonly isolated virus. Presence of specific viral genome was associated with a significant recovery in ejection fraction, compared to patients without viral evidence (p < 0.05). In Cox-regression analysis, higher survival rate was related to virus-positive biopsies (p < 0.05). When comparing long-term prognosis among different viral groups, a trend towards better prognosis was observed in the presence of isolated Parvovirus B19 (PVB19) (p = 0.07). In our series, presence of a virus-positive EMB (mainly PVB19) was associated with improvement over time in cardiac function and better long-term prognosis. View Full-Text
Keywords: myocarditis; cardiomyopathy; virus; echocardiography; biopsy; pediatric; longitudinal study myocarditis; cardiomyopathy; virus; echocardiography; biopsy; pediatric; longitudinal study
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Gagliardi, M.G.; Fierabracci, A.; Pilati, M.; Chinali, M.; Bassano, C.; Saura, F.; Giovannoni, I.; Francalanci, P. The Impact of Specific Viruses on Clinical Outcome in Children Presenting with Acute Heart Failure. Int. J. Mol. Sci. 2016, 17, 486.

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