Prevalence of viral genome in endomyocardial biopsies from patients with inflammatory heart muscle disease

In the report of the 1995 World Health Federation/International Society and Federation of Cardiology (WHF/ISFC) Task Force on the Definition and Class ification of Cardiomyopathies, the definition of heart muscle diseases was updated. Idiopathic, autoimmune, and infectious forms of inflammatory cardi omyopathy are now recognized in this definition. Enteroviruses, adenoviruse s and cytomegaloviruses are considered as main etiopathological factors in the pathogenesis of inflammatory heart disease. A wide range of different assays have been and are currently being used, ei ther alone or in combination, to assay for the presence of enteroviral RNA and/or DNA of cytomegalo-and adenoviruses in endomyocardial biopsy and expl anted heart samples. The prevalence of cardiotropic viruses in endomyocardi al biopsies of patients with clinically suspected inflammatory cardiomyopat hy varies widely: enteroviral genome was detected in endomyocardial biopsie s of 3 to 53% of patients, cytomegaloviral DNA was detected in 3 to 40% of patients with inflammatory heart disease and adenoviruses in 3 to 23% of th e patients. This report summarizes the methods that have been used and the results of m olecular biological investigation with polymerase chain reaction, which wer e reported by several groups over the last years. Taking this together it s eems to be clear that the improvement of molecular biological techniques an d the experience of people working with these methods will lead to more rel iable results on prevalence, persistence and the diagnostic value of these investigations. These findings have to be taken into account in future diag nostic and therapeutic studies in the field of cardiomyopathies.