Chronisch hartfalen (DCM) door Borrelia (ziekte van Lyme)

[bert]

http://www.ncbi.nlm.nih.gov/pubmed/1947816

Borrelia burgdorferi as an etiologic agent in chronic heart failure?Stanek G, Klein J, Bittner R, Glogar D.
Hygiene Institute, University of Vienna, Austria.

Since 1980 cardiac manifestations of Lyme borreliosis have been described as selflimited conduction and transient left ventricular disorders or even cardiomegaly.

An etiologic role of Borrelia burgdorferi in long-standing chronic heart disturbances is suggested by the cultivation of a strain of Borrelia burgdorferi which we were able to isolate from an endomyocardial biopsy of a patient with long-standing dilated cardiomyopathy.

[[i]In een patient met gedilateerde cardiomyopathie werd dmv een biopsie de spirocheet Borrelia gevonden, wat suggereert dat een Borrelia-infectie mogelijk de oorzaak van het hartfalen was].[/i]

The aim of this study was to acquire information about the prevalence of serum antibodies to Borrelia burgdorferi in patients with dilated cardiomyopathy.

By ELISA, we studied the sera of 72 consecutive patients with chronic heart failure due to dilated cardiomyopathy, of 55 patients with coronary heart disease, and of 61 healthy blood donors; positive ELISA values were determined in 26.4%, 12.7%, and 8.2% of serum samples, respectively.

These findings further suggest an association or even an etiologic role for Borrelia burgdorferi in dilated cardiomyopathy.

PMID: 1947816 [PubMed – indexed for MEDLINE]

Let wel: vaak kan Borrelia niet ontdekt worden in een gewone standaard ELISA (Lyme)-test (zoals die meestal wordt aangevraagd door artsen), maar deze test kan een infectie met Borrelia nooit uitsluiten.

[Lisa]

Reversal of Borrelia burgdorferi associated dilated cardiomyopathy by antibiotic treatment?

Gasser R, Fruhwald F, Schumacher M, Seinost G, Reisinger E, Eber B, Keplinger A, Horvath R, Sedaj B, Klein W, Pierer K.
Department of Medicine, University of Graz, Austria.

It is suggested that Borrelia burgdorferi infection could be associated with dilated cardiomyopathy (IDC). Stanek et al. (zie de studie hierboven) were able to cultivate Borrelia burgdorferi from myocardial biopsy tissue of a patient with longstanding dilated cardiomyopathy.

Here we present a study in which we examined the effect of standard antibiotic treatment on the left ventricular ejection fraction (LVEF) in patients with dilated cardiomyopathy associated with Borrelia burgdorferi infection.

In this study we assessed the serum (IgG, IgM Elisa) and history of 46 IDC patients with specific regard to Borrelia burgdorferi infection (mean LVEF 30.4 +/- 1.3%, measured by cardiac catheterization and echocardiography with the length-area-volume method).

All 46 patients received standard treatment for dilated cardiomyopathy: ACE inhibitors, digitalis, and diuretics.

Eleven (24%) patients showed positive serology and a history of Borrelia burgdorferi infection; nine of these also had a typical history of tick bite and erythema chronicum migrans (ECM) and/or other organ involvement, and two had no recollection of tick bite or ECM but showed other Borrelia burgdorferi-associated disorders (neuropathy, oligoarthritis).

These 11 patients with Borrelia burgdorferi infection received standard antibiotic treatment with intravenous ceftriaxone 2 g bid for 14 days. Six (55%) recovered completely and showed a normal LVEF after 6 months, three (27%) improved their LVEF, and two (18%) did not improve at all.

This amounts to nine (82%) patients with recovery/improvement in the Borrelia burgdorferi group.

The 35 patients who did not show positive serology or a history of Borrelia burgdorferi infection did not receive antibiotic treatment. In this group without Borrelia burgdorferi infection 12 (26%), showed recovery/improvement following the standard treatment of dilated cardiomyopathy (see earlier).

Our results indicate that Borrelia burgdorferi infection could play a decisive role in the development of dilated cardiomyopathy, especially in a geographical region such as Graz, where Borrelia burgdorferi is endemic.

While we are aware of the small number of Borrelia burgdorferi patients in this study, we nevertheless conclude that in a remarkable number of patients with signs of Borrelia burgdorferi infection, dilated cardiomyopathy could be reversed and LVEF improved.

PMID: 8877079 [PubMed – indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/8877079?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed

[Lisa]

Wat gaar er hieboven mis met de lay out???

[Vonne]

Kardiol Pol. 2009 May;67(5):516-20. Links

May Lyme borreliosis lead to heart transplantation? – a case report.

[Article in Polish]

Maroszyńska-Dmoch E, Wozakowska- Kapłon B.
I Oddzial Kardiologii, Swietokrzyskie Centrum Kardiologii, ul. Grunwaldzka 45, 25-736
Kielce, tel.: +48 41 367 13 01, e-mail: bw.kaplon@poczta.onet.pl.

A case of a 65-year-old man, who used to work as a forester for many years,
with end-stage dilated cardiomyopathy and subsequent heart transplantation is described.
Eight years later the diagnosis of Lyme borreliosis was established,
which was the likely cause of cardiac disease in this patient.

PMID: 19521937

[Auteur]

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