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. 1997 Dec;78(6):539–543. doi: 10.1136/hrt.78.6.539

Meta-analysis of the association of enteroviruses with human heart disease

C Baboonian 1, T Treasure 1
PMCID: PMC1892342  PMID: 9470867

Abstract

The role of viruses in the genesis of both dilated cardiomyopathy (DCM) and acute myocarditis remains uncertain. Modern molecular techniques such as polymerase chain reaction (PCR) and in situ hybridisation are sensitive means of detecting viral genomic material in human myocardial tissue and may help to resolve the quest. Meta-analysis of the papers in the literature records studies of both acute myocarditis and DCM where molecular techniques were used to demonstrate enteroviruses. This review studies information from the published literature as well as statistical analysis of the cumulative molecular data relating enteroviruses to DCM, and to compare these findings with the information available on the role of enteroviruses in acute myocarditis. Twelve papers reported studies in acute myocarditis, of which 11 found higher percentages of enteroviral RNA positivity in the diseased population, giving an overall odds ratio of 4.4. Seventeen papers reported studies in DCM, with 11 recording higher positivity rates in these patients. Cumulative analysis of these data suggests an overall odds ratio of 3.8. The causative role of enteroviruses in acute myocarditis, particularly in children, is supported by meta-analysis of the available literature. The data on DCM is suggestive of an association but a proportion of the studies are negative.

 Keywords: enteroviruses;  dilated cardiomyopathy;  myocarditis;  meta-analyses

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Figure 1  .

Figure 1  

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Evidence for association of enteroviruses with idiopathic myocarditis. The bar charts show the percentage of samples found to be positive with error bars showing the standard error of the binomial distribution. (X is the number of samples with enteroviral sequences and N the total number studied.)

Figure 2  .

Figure 2  

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Evidence for association of enteroviruses with dilated cardiomyopathy. The bar charts show the percentage of samples found to be positive with error bars showing the standard error of the binomial distribution. (X is the number of samples with enteroviral sequences and N the total number studied.)

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