Adenoviruses and enteroviruses as pathogens in myocarditis and dilated cardiomyopathy

Background Enteroviruses were detected in up to 50% in myocardium of patien ts with myocarditis and dilated cardiomyopathy, the latter being considered as a result of a prior subclinical myocarditis. A wide range of other infe ctious agents are being discussed as pathogens, often only based on reports of single cases. Adenovirus genome was recently identified in a significan t number in the myocardium of paediatric patients with myocarditis, However , data on the role of adenoviruses for the aetiopathogenesis of myocarditis in adult patients is missing so far. Therefore, we studied the prevalence of adenoviral and enteroviral genome in myocardium of adults with myocardit is and di fated cardiomyopathy. Methods 15 patients were diagnosed at baseline with myocarditis, 16 patient s with dilated cardiomyopathy according to clinical and histological criter ia. Endomyocardial biopsies of these patients and 8 control patients with n on-infectious heart diseases were evaluated by polymerase chain reactions f or enterovirus and adenovirus genome. Results Enteroviral genome was detected in 27.3% patients with myocarditis or dilated cardiomyopathy, whereas adenoviral genome was not identified in any patient. Samples from control subjects systematically yielded negative results. Conclusions From our data, it seems doubtful that adenoviruses are major pa thogens of myocarditis or DCM, whereas enterovirus genome was identified in a significant number of patients with both diseases.