Pathogenesis of hypertrophic cardiomyopathy associated with hepatitis C virus.

最近，丙型肝炎病毒（HCV）感染在肥厚型心肌病（HCM）或扩张型心肌病（DCM）患者中的重要性已被注意到。在特发性心肌病研究委员会的一项合作研究项目中，697例HCM患者中有74例（10.6%）发现HCV抗体，663例DCM患者中有42例（6.3%）发现HCV抗体；这一流行率明显高于日本志愿献血者（2.4%）。一项由b博士主持的多中心合作研究。Maisch，对福尔马林固定组织中肠病毒、腺病毒、巨细胞病毒和丙型肝炎病毒等病毒基因组检测的重复性进行检验。对尸检和活检资料进行盲目分析。在意大利11例扩张型心肌病和心肌炎患者中2例（18%）的心脏中发现了丙型肝炎病毒基因组，在美国11例患者中4例（36%）的心脏中发现了丙型肝炎病毒基因组。我们试图在解剖心脏的石蜡切片中检测HCV基因组。在106颗心脏中，61颗（52.6%）的β-肌动蛋白基因扩增。其中，13例（21.3%）心脏检出HCV RNA， 4例（6.6%）心脏检出阴性链。HCV RNA出现在HCM患者6例（26.0%），DCM患者3例（11.5%），心肌炎患者4例（33.3%）。这些HCV RNA阳性样本是在1979年至1990年间获得的，表明保存多年的石蜡包埋心脏可以扩增出HCV RNA。在与犹他大学的合作研究中，我们还分析了患有DCM的尸检心脏，发现23颗心脏中有8颗（35%）的HCV RNA呈肌动蛋白基因阳性。从这些心脏中恢复的HCV基因组序列与HCV标准株密切同源。

The importance of hepatitis C virus (HCV) infection has recently been noted in patients with hypertrophic cardiomyopathy (HCM) or dilated cardiomyopathy (DCM).In a collaborative research project of the Committees for the Study of Idiopathic Cardiomyopathy, HCV antibody was found in 74 of 697 patients (10.6%) with HCM and in 42 of 663 patients (6.3%) with DCM; this prevalence was significantly higher than measured in volunteer blood donors in Japan (2.4%).A collaborative multicenter study, chaired by Dr.B.Maisch, was performed to test the reproducibility of detection of detection of viral genomes such as enteroviruses, adenovirus, cytomegalovirus and HCV in formalin fixed tissues. Autopsy and biopsy materials were analyzed blindly. Hepatitis C virus genomes were found in the hearts of 2 out of 11 patients (18%) with dilated cardiomyopathy and myocarditis from Italy, and 4 out of 11 patients (36%) from the United States. We attempted to detect HCV genomes in paraffin sections of autopsied hearts. Among 106 hearts examined, β-actin gene was amplified in 61 hearts (52.6%). Among these, HCV RNA was detected in 13 hearts (21.3%), and negative strands in 4 hearts (6.6%). HCV RNA was found in 6 hearts (26.0%) with HCM, 3 heart (11.5%) with DCM, and 4 hearts (33.3%) with myocarditis. These HCV RNA positive samples were obtained between 1979 and 1990, indicating that HCV RNA can be amplified from paraffin-embedded hearts preserved for many years. We also analyzed autopsied hearts with DCM in a collaborative research with the University of Utah, and found HCV RNA in 8 of 23 hearts (35%) with positive actin genes. The sequences of HCV genomes recovered from these hearts were closely homologous to the standard strain of HCV.