Volume 17 Supplement 1

Abstracts of the 18th Annual SCMR Scientific Sessions

Open Access

Predictors of outcome in patients with parvovirus B19 positive endomyocardial biopsy

  • Simon Greulich1,
  • Ingrid Kindermann2,
  • Julia Schumm3,
  • Andrea Perne4,
  • Stefan Birkmeier1,
  • Stefan Grün1,
  • Peter Ong1,
  • Tim Schäufele1,
  • Steffen Schneider5,
  • Michael Böhm2,
  • Udo Sechtem1 and
  • Heiko Mahrholdt1
Journal of Cardiovascular Magnetic Resonance201517(Suppl 1):O80

https://doi.org/10.1186/1532-429X-17-S1-O80

Published: 3 February 2015

Background

The primary objective of this study was to establish the prognostic value of the myocardial load of PVB19 genomes in patients presenting for endomyocardial biopsy work-up of myocarditis and/or dilated cardiomyopathy in comparison to clinical, and cardiovascular MR parameters.

Methods

108 consecutive patients who underwent EMB because of suspected myocarditis and/or dilated cardiomyopathy, and had evidence of myocardial PVB19 by PCR were enrolled. The mean follow-up was 1319 days. Primary endpoint was all-cause mortality, secondary endpoint was a composite of cardiac mortality and hospitalization for heart-failure.

Results

Mean ejection fraction of all patients was 40%. We found n=27 patients to have a viral load ≥500 GE, n= 72 had 100-499 GE and n=9 had <100 GE. Immunohistology revealed chronic myocarditis in n=66 patients, DCM in n=17, other pathologies in n=12 (including 1 acute myocarditis), and latent PVB19 in n=13. During follow-up 11 of 108 patients died, two patients suffered SCD but were successfully shocked by their ICD, and 21 patients were hospitalized for heart failure.

Interestingly, not the viral load, but functional parameters such as LV-EF, LV-EDV (for endpoint 2), as well as the histologic diagnosis of DCM and the presence of LGE (for all endpoints) reached statistical significance. In fact, the presence of LGE yields an odds-ratio for a lethal event of 8.56 (endpoint 1), and of 5.52 for endpoint 2.

Importantly, no patient with normal LV-EF, or the absence of LGE suffered cardiac death during long-term follow-up.

Conclusions

The viral load of PVB19 genomes in the myocardium is not related to the long-term clinical outcome. Furthermore, this study underscores the growing role of imaging parameters for risk-stratification of patients with non-ischemic myocardial disease.

Funding

This work was funded in part by the Robert Bosch Foundation [1) clinical research grant for CMR risk stratification in HCM and 2) clinical research grant for inflammatory heart disease KKF-11-18, KKF-13-2].

Authors’ Affiliations

(1)
Cardiology, Robert Bosch Medical Center
(2)
Klinik für Innere Medizin 3, Universitätsklinikum Saarland
(3)
Cardiology, Horst-Schmidt-Kliniken
(4)
Medicine 2, University Medical Center of the Johannes Gutenberg University Mainz
(5)
Institut für Herzinfarktforschung Ruhr

Copyright

© Greulich et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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