Clinical Investigations Serological Evidence for the Association of Bartonella henselae Infection with Arrhythmogenic Right Ventricular Cardiomyopathy
Address for correspondence: Rolf Jenni, MD Clinic of Cardiology University Hospital Zurich Raemistr. 100, CH-8091 Zurich, Switzerland
[email protected]
Andreas H. Fischer, MD,∗ Bernd van der Loo, MD,∗ Gertrud M. Sch¨ ar, MD,† Reinhard Zbinden, MD, MSc,† Firat Duru, MD,∗ Corinna Brunckhorst, MD,∗ Valentin Rousson, PhD,‡ Etienne Delacr´etaz,MD,¶ Thomas Stuber, MD,¶ Erwin N. Oechslin, MD,∗ Ferenc Follath, MD,§ Rolf Jenni, MD∗ ∗
Clinic of Cardiology; † Institute of Microbiology; ‡ Department of Biostatistics, Institute of Social and Preventative Medicine; § Department of Internal Medicine, University Hospital Zurich, Zurich; ¶ Department of Cardiology, Inselspital University Hospital Berne, Berne, Switzerland
Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden death in young adults. On the basis of histopathological findings its pathogenesis may involve both a genetic origin and an inflammatory process. Bartonella henselae may cause endomyocarditis and was detected in myocardium from a young male who succumbed to sudden cardiac death. Hypothesis: We hypothesized that chronic infection with Bartonella henselae could contribute to the pathogenesis of ARVC. Methods: We investigated sera from 49 patients with ARVC for IgG antibodies to Bartonella henselae. In this study, 58 Swiss blood donors tested by the same method served as controls. Results: Six patients with ARVC (12%) had positive (>1:256) IgG titres in the immunofluorescence test with Bartonella henselae. In contrast, only 1 elevated titre was found in 58 controls (p1:256 considered positive) and (B) distribution of IgG antibody concentrations to Bartonella henselae in familial and nonfamilial ARVC cases A
Control
Bartonella henselae IgG Titre Positive
Negative
1
57 p