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2021-12-14Zeitschriftenartikel
Transcriptional Active Parvovirus B19 Infection Predicts Adverse Long-Term Outcome in Patients with Non-Ischemic Cardiomyopathy
dc.contributor.authorEscher, Felicitas
dc.contributor.authorAleshcheva, Ganna
dc.contributor.authorPietsch, Heiko
dc.contributor.authorBaumeier, Christian
dc.contributor.authorGross, Ulrich M.
dc.contributor.authorSchrage, Benedikt Norbert
dc.contributor.authorWestermann, Dirk
dc.contributor.authorBock, Claus-Thomas
dc.contributor.authorSchultheiss, Heinz-Peter
dc.date.accessioned2024-06-10T12:14:09Z
dc.date.available2024-06-10T12:14:09Z
dc.date.issued2021-12-14none
dc.identifier.other10.3390/biomedicines9121898
dc.identifier.urihttp://edoc.rki.de/176904/11701
dc.description.abstractParvovirus B19 (B19V) is the predominant cardiotropic virus currently found in endomyocardial biopsies (EMBs). However, direct evidence showing a causal relationship between B19V and progression of inflammatory cardiomyopathy are still missing. The aim of this study was to analyze the impact of transcriptionally active cardiotropic B19V infection determined by viral RNA expression upon long-term outcomes in a large cohort of adult patients with non-ischemic cardiomyopathy in a retrospective analysis from a prospective observational cohort. In total, the analyzed study group comprised 871 consecutive B19V-positive patients (mean age 50.0 ± 15.0 years) with non-ischemic cardiomyopathy who underwent EMB. B19V-positivity was ascertained by routine diagnosis of viral genomes in EMBs. Molecular analysis of EMB revealed positive B19V transcriptional activity in n = 165 patients (18.9%). Primary endpoint was all-cause mortality in the overall cohort. The patients were followed up to 60 months. On the Cox regression analysis, B19V transcriptional activity was predictive of a worse prognosis compared to those without actively replicating B19V (p = 0.01). Moreover, multivariable analysis revealed transcriptional active B19V combined with inflammation [hazard ratio 4.013, 95% confidence interval 1.515–10.629 (p = 0.005)] as the strongest predictor of impaired survival even after adjustment for age and baseline LVEF (p = 0.005) and independently of viral load. The study demonstrates for the first time the pathogenic clinical importance of B19V with transcriptional activity in a large cohort of patients. Transcriptionally active B19V infection is an unfavourable prognostic trigger of adverse outcome. Our findings are of high clinical relevance, indicating that advanced diagnostic differentiation of B19V positive patients is of high prognostic importance.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectparvovirus B19eng
dc.subjecttransriptional activityeng
dc.subjectdilated inflammatory cardiomyopathyeng
dc.subjectlong-term outcomeeng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleTranscriptional Active Parvovirus B19 Infection Predicts Adverse Long-Term Outcome in Patients with Non-Ischemic Cardiomyopathynone
dc.typearticle
dc.identifier.urnurn:nbn:de:0257-176904/11701-6
dc.type.versionpublishedVersionnone
local.edoc.container-titlebiomedicinesnone
local.edoc.container-issn2227-9059none
local.edoc.pages14none
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://www.mdpi.com/journal/biomedicinesnone
local.edoc.container-publisher-nameMDPInone
local.edoc.container-volume9none
local.edoc.container-issue12none
local.edoc.container-reportyear2021none

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