The role of cytomegalovirus infection in ischemic heart failure progression

Abstract Objective To study an association between cytomegalovirus infection (CMV) and molecular biomarkers (NT-proBNP, tumor necrosis factor (TNF-α), Interleukin-1β) and evaluate prognostic role of CMV infection in ischemic heart failure (HF) progression during the 12-month follow-up period. Methods A total of 104 patients (61.5% men, median age of 59 [53; 62.5] years) with stable coronary artery disease and baseline left ventricular ejection fraction (LVEF) of 43% [36; 57]% were enrolled in the study. At baseline evaluation HF patients were of New York Heart Association (NYHA) class I (7.7%), class II (61.0%), and class III (31.3%). Sixty five percent of patients had prior myocardial infarction and 70.2% received prior myocardial revascularization (coronary artery bypass graft/stent). Cytomegalovirus DNA concentrations in EDTA whole-blood samples were measured using a polymerase chain reaction baseline and at 12 months of follow-up period. Serum levels of NT-proBNP, Interleukin-1β, TNF-α were measured baseline using an enzyme immunoassay. Two-dimensional transthoracic echocardiography was performed at baseline and at the 12 months. Results At baseline, all patients were divided into 2 groups: group A comprised CMV seropositive patients (n=52); group B comprised CMV seronegative patients (n=52). Plasma concentration of cytomegalovirus DNA was 1709.4 [615; 3176] copies/mL. The values of cytomegalovirus DNA significantly correlated with NT-proBNP (r=0.781), TNF-α (r=0.799) and Interleukin-1β (r=0.756). Levels of NT-proBNP were higher (p=0.0001) in group A by 36.6% than in group 2 (559 [364; 756] vs. 354.5 [279; 545.5] pg/mL, respectively). Levels of TNF-α were also higher (p