Features of the course of acute decompensated ischemic heart failure and/or ongoing adverse left ventricular remodeling in patients with identified human herpes virus type 6

Features of the course of acute decompensated ischemic heart failure and/or ongoing adverse left ventricular remodeling in patients with identified human herpes virus type 6

Автор: Kruchinkina E.V., Ogurkova O.N., Gusakova A.M., Suslova T.E., Ryabov V.V.

Журнал: Сибирский журнал клинической и экспериментальной медицины @cardiotomsk

Рубрика: Клинические исследования

Статья в выпуске: 3 т.36, 2021 года.

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Objective. To determine serum levels of immunoglobulin M (IgM) and G (IgG) antibodies to human herpes virus type 6 (HHV-6) (anti-HHV-6) and features of clinical and morphological portrait in patients with acute decompensated heart failure (ADHF) of ischemic genesis and/or adverse left ventricular (LV) remodeling.Material and Methods. This open-label, nonrandomized, single-center, prospective trial was registered at clinicaltrials. gov (#NCT02649517) and comprised 25 patients (84% men) with ADHF and LV ejection fraction (EF) ≤ 40%. All patients underwent endomyocardial biopsy (EMB) with immunohistochemistry (IHC) analysis for the presence of HHV-6, compliment C1q, major histocompatibility complex of class II (MHC II), and B-lymphocyte antigen (CD19) as the markers of autoimmune reaction as well as the serum levels of anti-HHV-6 IgM and IgG. Serum levels of IgM and IgG were measured using enzymelinked immunosorbent assay (ELISA) with the calculation of positivity coefficient (PC) according to manufacturer instructions. The test results were interpreted as positive when PC value was greater than 0.8.Results. The endomyocardial biopsy study detected HHV-6 antigen expression in 15 (60%) out of 25 enrolled patients including 10 cases with diagnosed HHV-6-positive myocarditis and five patients with carriage of viruses. According to IHC, the autoimmune HHV-6 myocarditis was confirmed in three cases (30%). The data of ELISA (n = 18) detected anti-HHV-6 IgM in 5 patients (28%) and anti-HHV-6 IgG in 11 cases (61%). The simultaneous presence of both anti-HHV-6 IgM and IgG was detected in two patients (11%). In addition, anti-HHV-6 IgM and IgG were absent in two (11%) cases. Eight patients (44%) with HHV-6-positive myocarditis included three patients (17%) tested positive for serum anti-HHV-6 IgM, three patients (17%) tested positive for serum anti-HHV-6 IgG, and two patients (11%) who had nether anti-HHV-6 IgM nor anti-HHV-6 IgG in blood serum. Among virus carriers, one patient (20%) was tested positive for anti-HHV-6 IgM and four patients (80%) were tested positive for anti-HHV-6 IgG. The patients without HHV-6 antigen expression (n = 5, 28%) included one patient (5.6%) tested positive for anti-HHV-6 IgM and two patients (11%) tested positive for anti-HHV-6 IgG. The entire sample of patients was divided into two groups depending on the serum level of anti-HHV-6 IgM: group 1 comprised patients tested positive for anti-HHV-6 IgM (n = 5); group 2 comprised patients (n = 13) tested negative for anti-HHV-6 IgM. Clinical and instrumental parameters differed only in the duration of CHF history, which was greater in group 1 than in group 2 (11.0 [8.0; 12.0] vs. 22.5 [14.5; 75.5] months, respectively (p = 0.045). The groups did not significantly differ in the studied markers in myocardial tissue according to the results of IHC analysis. No associations were found between the severity of HHV-6 antigen expression and serum levels of anti-HHV-6 IgM and IgG.Conclusion. Patients with ADHF and/or adverse LV remodeling after complete myocardial revascularization had higher percentage of HHV-6 antigen expression whose severity was not associated with the serum levels of anti-HHV-6 IgM and IgG.

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Acute decompensated heart failure, adverse left ventricular remodeling, human herpesvirus type 6, ischemic heart disease, endomyocardial biopsy, anti-hhv-6 igm and igg

Короткий адрес: https://sciup.org/149139341

IDR: 149139341   |   DOI: 10.29001/2073-8552-2021-36-3-111-118

Список литературы Features of the course of acute decompensated ischemic heart failure and/or ongoing adverse left ventricular remodeling in patients with identified human herpes virus type 6

  • Virani S.S., Alonso A., Benjamin E.J., Bittencourt M.S., Callaway C.W., Carson A.P. et al. Heart Disease and Stroke Statistics - 2020 Update: A Report From the American Heart Association. Circulation. 2020;141(9):e139-e596. DOI: 10.1161/CIR.0000000000000757.
  • Degoricija V., Trbusic M., Potocnjak I., Radulovic B., Teresak D.S., Pre-gartner G. et al. Acute Heart Failure developed as worsening of Chronic Heart Failure is associated with increased mortality compared to de novo cases. Sci. Rep. 2019;9(1):8403. DOI: 10.1038/s41598-019-44069-7.
  • Farmakis D., Parissis J., Lekakis J., Philippathos G. Acute Heart Failure: Epidemiology, risk factors, and prevention. Rev. Esp. Cardiol. (Engl. Ed.). 2015;68(3):245-248. DOI: 10.1016 / j.rec.2014.11.004.
  • Rich J.D., Burns J., Freed B.H., Maurer M.S., Burkhoff D., Shah S.J. et al. Meta-analysis Global Group in Chronic Heart Failure (MAGGIC): Validation of a Simple Tool for the Prediction of Morbidity and Mortality in Heart Failure With Preserved Ejection Fraction. J. Am. Heart Assoc. 2018;7(20):e009594. DOI: 10.1161/JAHA.118.009594.
  • Pryds K., Schmidt M.R., Bjerre M., Thiel S., Refsgaard J., B0tker H.E. et al. Effect of long-term remote ischemic conditioning on inflammation and cardiac remodeling. Scand. Cardiovasc J. 2019;53(4):183-191. DOI: 10.1080/14017431.2019.1622770.
  • Bacmeister L., Schwarzl M., Warnke S., Stoffers B., Blankenberg S., Westermann D. et al. Inflammation and fibrosis in murine models of heart failure. Basic Res. Cardiol. 2019;114(3):19. DOI: 10.1007/s00395-019-0722-5.
  • Kercheva M., Gusakova A.M., Ryabova T.R., Suslova T.E., Kzhyshkows-ka J., Ryabov V.V. Serum levels of bone morphogenetic proteins 2 and 4 in patients with acute myocardial infarction. Cells. 2020;9(10):2179. DOI: 10.3390/cells9102179.
  • Mozaffarian D., Benjamin E.J., Go A.S., Arnett D.K., Blaha M.J., Cush-man M. et al. Heart Disease and Stroke Statistics - 2016 Update. A Report from the American Heart Association. Circulation. 2016;133(4):e38-e360. DOI: 10.1161/CIR.0000000000000350.
  • Bertero E., Störk S., Maack C. REPORT-HF reveals global inequalities in health care provision and prognosis of patients with acute heart failure. Cardiovasc. Res. 2020;116(10):e112-e114. DOI: 10.1093/cvr/cvaa194.
  • Zhang Y., Bauersachs J., Langer H.F. Immune mechanisms in heart failure. Eur. J. Heart Fail. 2017;19(11):1379-1389. DOI: 10.1002/ejhf.942.
  • Caforio A.L., Pankuweit S., Arbustini E., Basso C., Gimeno-Blanes J., Felix S.B. et al. Current state of knowledge on aetiology, diagnosis,
  • management, and therapy of myocarditis: A position statement of the European Society of Cardiology Working Groupon Myocardial and Peri-cardial Diseases. Eur. Heart J. 2013;34(33):2636-2648, 2648a-2648d. DOI: 10.1093/eurheartj/eht210.
  • Maisch B., Alter P. Treatment options in myocarditis and inflammatory cardiomyopathy. Herz. 2018;43(5):423-430. DOI: 10.1007/s00059-018-4719-x.
  • Tschöpe C., Ammirati E., Bozkurt B., Caforio A.L., Cooper L.T., Felix S.B. et al. Myocarditis and inflammatory cardiomyopathy: Current evidence and future directions. Nat. Rev. Cardiol. 2021;18(3):169-193. DOI: 10.1038/s41569-020-00435-x.
  • Agut H., Bonnafous P., Gautheret-Dejean A. Laboratory and clinical aspects of human herpesvirus 6 infections. Clin. Microbiol. Rev. 2015;28(2):313-335. DOI: 10.1128/CMR.00122-14.
  • De Bolle L., Naesens L., De Clercq E. Update on human herpes-virus 6 biology, clinical features, and therapy. Clin. Microbiol. Rev. 2005;18(1):217-245. DOI: 10.1128/CMR.18.1.217-245.2005.
  • Lang R.M., Badano L.P., Mor-Avi V., Afilalo J., Armstrong A., Ernande L. et al. Recommendations for cardiac chamber quantification by echo-cardiography in adults: an update from the American Society of Echo-cardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr. 2015;28(1):1-39.e14. DOI: 10.1016/j. echo.2014.10.003.
  • Caforio A.L., Marcolongo R., Jahns R., Fu M., Felix S.B., Iliceto S. Immune-mediated and autoimmune myocarditis: Clinical presentation, diagnosis and management. Heart Fail. Rev. 2013;18(6):715-732. DOI: 10.1007/s10741-012-9364-5.
  • Basso C., Calabrese F., Angelini A., Carturan E., Thiene G. Classification and histological, immunohistochemical, and molecular diagnosis of inflammatory myocardial disease. Heart Fail. Rev. 2013;18(6):673-681. DOI: 10.1007/s10741-012-9355-6.
  • Maisch B., Pankuweit S. Inflammatory dilated cardiomyopathy: Etiology and clinical management. Herz. 2020;45(3):221-229. DOI: 10.1007/ s00059-020-04900-8.
  • Escher F., Kühl U., Gross U., Westermann D., Poller W., Tschöpe C. et al. Aggravation of left ventricular dysfunction in patients with biopsy-proven cardiac human herpesvirus A and B infection. J. Clin. Virol. 2015;63:1-5. DOI: 10.1016/j.jcv.2014.11.026.
  • Шарипова Е.В., Бабаченко И.В., Левина А.С. Поражение сердечно-сосудистой системы при вирусных инфекциях. Журнал инфек-тологии. 2017;9(4):14-23. DOI: 10.22625/2072-6732-2017-9-4-14-23. Sharipova E.V., Babachenko I.V., Levina A.S. Defeat of the cardiovascular system in viral infections. Journal Infectology. 2017;9(4):14-23 (In Russ.). DOI: 10.22625/2072-6732-2017-9-4-14-23.
  • Никитская Е.А., Марюхнич Е.В., Саввинова П.П., Пинегина Н.В., Шпектор А.В., Васильева Е.Ю. и др. Вирусы герпеса человека и атеросклероз. Современный взгляд. Креативная кардиология. 2015;9(2):54-62. DOI: 10.15275/kreatkard.2015.02.05. Nikitskaya E.A., Maryukhnich E.V., Savvinova P.P., Pinegina N.V., Shpektor A.V., Vasilieva E.Yu. et al. Human herpesviruses and atherosclerosis. Modern point of view. Creative Cardiology. 2015;9(2):54-62 (In Russ.). DOI: 10.15275/kreatkard.2015.02.05.
  • King O., Al Khalili Y. Herpes virus type 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
  • Mahfou F., Gartner B., Kindermann M., Ukena C., Gadomski K., Klingel K. et al. Virus serology in patients with suspected myocarditis: Utility or futility? Eur. Heart J. 2011;32(7):897-903. DOI: 10.1093/eurheartj/ehq493.
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