Relationship Between Viral Infection And Serum Fibrotic Markers In Dilated Cardiomyopathy

Objective To study the relative diagnostic value of Coxsackie virus serological assay and serum fibrotic markers in patients with dilated cardiomyopathy, and their intrrelation. Design-analysis of serum from patients with dilated cardiomyopathy and controls.Methods Determination of antibodies to Coxsackie virus in human serum by Cox-Ab ELISA test; radioimmunoassay kits were used for measurements of type Ⅲ procollagen, and type Ⅳ collagen.Results Coxsackie-specific immunoglobulin was detected in 25 (65.8%) of 38 patients with dilated cardiomyopathy, but in only 7(18.9%) of 37 apparently healthy persons. There was statistically significant difference in prevalence of Coxsackie-specific immunoglobulin between patients with dilated cardiomyopathy and controls (P<0.001; Fisher' s exact test). PC Ⅲ serum concentration averaged 128.69±4.12 micrograms/L, was significantly increased in the dilated cardiomyopathygroup than in the control group [93.19±4.10 micrograms/L; t test; P<0.001]. There is also a significantly increased PC Ⅳ serum concentration averaged 113.84±5.23 micrograms/L in the dilated cardiomyopathy than in control group[ 84.14±2.55 micrograms/L; t test; P<0.001]. There is no significant difference in prevalence of Coxsackie-specific immunoglobulin, PC Ⅲserum concentration, or PC Ⅳ serum concentration between patients with cardiac arrhythmia and patients without cardiac arrhythmia. The different clinical classes of NYHA showed no significant difference in prevalence of Coxsackie-specific immunoglobulin, PC Ⅲ serum concentration, or PC Ⅳ serum concentration. In our study there is no correlation between the prevalence of Coxsackie-specific and PC Ⅲ serum concentration, or PC Ⅳ serum concentration.Conclusion This study found that Coxsackie-virus immunoglobulin responses provided the strongest evidence of Coxsackie-virus involvement in patients with different stages of dilated cardiomyopathy. However, the high background prevalence of these responses limits their diagnosis. The high concentrations of serum fibrotic markers may be useful pathologic indicators in patients with dilated cardiomyopathy. In our study there is no correlation found between the Coxsackie-virus immunoglobulin responses and serum fibrotic markers indicates that these are independent markers of this disease.