Direct Damage of Myocardium by Enterovirus
Human idiopathic myocarditis has long troubled those interested in establishing cause(s) and identifying efficacious therapies. To date, neither the cause nor specific therapies are known. Perhaps these difficulties relate to the ambiguities of clinical presentation, the poorly characterized natural history, and the lack of distinctive therapeutic targets. Nonetheless, continued efforts worldwide to understand inflammatory heart disease have reestablished a view that viruses, and particularly enteroviruses, play a pathogenetic role in at least some human myocarditides. Summary experience from several investigators suggests that approximately 25% of inflamed failing and/or arrhythmic hearts are attributable to enterovirus infections [1, 2]. The frequency of other community-acquired viral infections involving the heart is much less clear. Even more uncertain is the manner in which viruses may effect injury in the human heart. Hypotheses abound, but little in the way of solid data is available. The role of virus in direct injury of the myocardium has appeared more convincing in fulminant infantile myocarditis where enterovirus is often isolated and/or demonstrated by molecular techniques (McManus, unpublished data). Autoimmune phenomena are often concomitants of human myocarditis and dilated cardiomyopathy , but their pathogenetic significance has not been established.
KeywordsSilanated Citrate Interferon Paraffin Cardiomyopathy
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