{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:23:19Z","timestamp":1793316199599,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2005,9,27]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Cardiotropic viral infections have been suspected as one possible cause of myocarditis and dilated cardiomyopathy. Although adverse outcomes in dilated cardiomyopathy patients have been documented, the natural course of heart diseases caused by cardiotropic viruses is unknown.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Consecutive patients (n=172) with biopsy-proven viral infection in endomyocardial biopsies (EMBs) were followed up by reanalysis of EMBs and hemodynamic measurements after a median period of 6.8 months (range, 5.4 to 11.9). Nested polymerase chain reaction (PCR) and reverse transcription\u2013PCR were performed to analyze the genomic sequences. Myocardial inflammation was assessed by histology and immunohistology. At baseline, 32.6% of EMBs in the study group contained enteroviral (EV) RNA, 8.1% adenovirus (ADV) DNA, 36.6% parvovirus B19 (PVB19) DNA, and 10.5% human herpesvirus type 6 (HHV6) DNA. In 12.2% of the samples, dual infection with PVB19 and HHV6 was present. Follow-up analysis of EMBs by PCR documented spontaneous clearance of viral genomes in 36.2% (55\/151) of all patients with single infections. Virus-specific clearance rates were 50% for EV, 35.7% for ADV, 22.2% for PVB19, and 44.4% for HHV6. In patients with dual infection with PVB19\n                    <jats:sup>+<\/jats:sup>\n                    and HHV6\n                    <jats:sup>+<\/jats:sup>\n                    -, HHV6 was cleared in 42.8% (9\/21), whereas PVB19 persisted in all 21 patients. Clearance of viral genomes was associated with a significant improvement in left ventricular ejection fraction (LVEF), improving from 50.2\u00b119.1% to 58.1\u00b115.9% (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). In contrast, LV function decreased in patients with persisting viral genomes (LVEF, 54.3\u00b116.1% versus 51.4\u00b116.1%,\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.01).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    In this first biopsy-based analysis of the course of viral heart disease, we show that EV, ADV, PVB19, and HHV6 persistence detected in the myocardium of patients with LV dysfunction was associated with a progressive impairment of LVEF, whereas spontaneous viral elimination was associated with a significant improvement in LV function.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.105.548156","type":"journal-article","created":{"date-parts":[[2005,9,19]],"date-time":"2005-09-19T20:25:59Z","timestamp":1127161559000},"page":"1965-1970","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":501,"title":["Viral Persistence in the Myocardium Is Associated With Progressive Cardiac Dysfunction"],"prefix":"10.1161","volume":"112","author":[{"given":"Uwe","family":"Ku\u0308hl","sequence":"first","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pauschinger","sequence":"additional","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Seeberg","sequence":"additional","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Lassner","sequence":"additional","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Noutsias","sequence":"additional","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Poller","sequence":"additional","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz-Peter","family":"Schultheiss","sequence":"additional","affiliation":[{"name":"From Charite, Universita\u0308tsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik II, Abteilung fu\u0308r Kardiologie und Pneumologie, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011093431908"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.93.5.841"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000085168.02782.2c"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000155616.07901.35"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.78.6.539"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.99.7.889"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00648-X"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.89.6.8205668"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000048147.15962.31"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000155615.68924.b3"},{"key":"e_1_3_2_11_2","first-page":"3","volume":"1","year":"1987","unstructured":"Aretz HT, Billingham ME, Edwards WD, Factor SM, Fallon JT, Fenoglio JJ Jr, Olsen EG, Schoen FJ. Myocarditis: a histopathologic definition and classification. Am J Cardiovasc Pathol. 1987; 1: 3\u201314.","journal-title":"Am J Cardiovasc Pathol"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000072766.67150.51"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/321674a0"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0042-6822(90)90205-6"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.75.3.295"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.99.16.2124"},{"key":"e_1_3_2_17_2","first-page":"92","volume":"34","year":"2002","unstructured":"Bueltmann BD, Klingel K, Soltar K, Bock CT, Baba HA, Sauter M, Kandolf R. Fatal parvovirus B19-associated myocarditis clinically mimicking ischemic heart disease: an endothelial cell-mediated disease. Human Pathol. 2002; 34: 92\u201395.","journal-title":"Human Pathol"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.72.6.561"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.94.11.2930"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9071(199706)52:2<206::AID-JMV15>3.0.CO;2-I"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.95.4.778"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.14.1382"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.10.1017"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/76277"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.1033"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.18.2276"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(97)00217-4"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:HREV.0000011391.81676.3c"},{"key":"e_1_3_2_29_2","first-page":"79","volume":"88","year":"1993","unstructured":"Klingel K, Kandolf R. The role of enterovirus replication in the development of acute and chronic heart muscle disease in different immunocompetent mouse strains. Scand J Infect Dis Suppl. 1993; 88: 79\u201385.","journal-title":"Scand J Infect Dis Suppl"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/6543"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.105.548156","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T01:08:40Z","timestamp":1715562520000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.105.548156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,9,27]]},"references-count":30,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2005,9,27]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.105.548156"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.105.548156","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,9,27]]},"assertion":[{"value":"2005-09-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}