ANALYSIS OF FORMALIN-FIXED AND FROZEN MYOCARDIAL AUTOPSY SAMPLES FOR VIRAL GENOME IN CHILDHOOD MYOCARDITIS AND DILATED CARDIOMYOPATHY WITH ENDOCARDIAL FIBROELASTOSIS USING POLYMERASE CHAIN-REACTION (PCR)

Viral infection of the myocardium is implicated in the pathogenesis of myocarditis and dilated cardiomyopathy (DCM). Enteroviruses have been considered the most common viral etiologic agents, based on periphera l culture and serologic methods. Recently, polymerase chain reaction ( PCR) has been shown to be useful in the detection of viral genomes fro m various infected organs and body fluids. In this study, myocardial s amples from autopsy specimens (formalin fixed and fresh frozen) were e xamined for enteroviral and DNA viral (adenovirus, herpes simplex viru s [HSV], and cytomegalovirus (CMV]) genome by PCR. The specimens studi ed were from 58 patients with myocarditis, 28 patients with DCM and en docardial fibroelastosis [EFE], and 22 controls. Viral genome was dete ctable in 34 of the 58 (59%) autopsy-proven myocarditis samples (18 ad enovirus, 12 enterovirus, 2 CMV, 2 HSV) and 6 of the 28 samples from p atients with DCM and EFE (6 adenovirus). We conclude that PCR is effec tive in the rapid amplification of virus from frozen and formalin-fixe d myocardial samples and that adenovirus is an important etiologic age nt in viral myocarditis as well as DCM with EFE.