Cardiac myocytes of hearts from patients with end-stage dilated cardiomyopathy do not contain Borrelia burgdorferi DNA

Objective To determine if end-stage dilated cardiomyopathy (DCM) is associa ted with the presence of Lyme disease causing spirochete Borrelia burgdorfe ri in the myocardium, we used nested polymerase chain reaction to detect B burgdorferi DNA in myocardial samples from explanted hearts of patients wit h end-stage DCM. patients originated from endemic areas for Lyme disease (B avaria, Lower Saxony, Germany). Methods and Results This was a retrospective study. Polymerase chain reacti on was used to detect the specific B burgdorferi recombinant outer surface protein A (OspA) gene in myocardial tissue from 68 patients with end-stage DCM who had undergone heart transplantation. The clinical history of lyme d isease, the presence of Borrelia burgdorferi OspA, and antibodies against O spA in myocardial tissue and serum were investigated. B burgdorferi DNA was not detected in an of the 68 human hearts. Immunoglobulin G antibodies aga inst specific B burgdorferi antigens were observed in 3 (12.5%) of 24 patie nts. In contrast, 4 hearts from rats experimentally infected with B burgdor feri were all positive for OspA DNA as measured by polymerase chain reactio n. Conclusion Our data show that cardiac myocytes of hearts obtained from subj ects with end-stage DCM did not contain B burgdorferi DNA as investigated b y polymerase chain reaction. However, B burgdorferi shows a high affinity f or myocardial tissue as shown by the animal studies, indicating that myocar dial infections are nevertheless possible.