Format

Send to

Choose Destination
Herz. 2015 Sep;40(6):892-7. doi: 10.1007/s00059-015-4308-1. Epub 2015 May 5.

Recent-onset dilated cardiomyopathy associated with Borrelia burgdorferi infection.

Author information

1
2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic.
2
International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic.
3
2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic. tpalec@lf1.cuni.cz.
4
International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic. tpalec@lf1.cuni.cz.
5
Institute of Pathology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
6
The National Institute of Public Health, Prague, Czech Republic.

Abstract

BACKGROUND:

Several recent small studies have suggested a causal link between Lyme disease and dilated cardiomyopathy (DCM) by demonstrating the presence of the Borrelia burgdorferi (Bb) genome in the myocardium of patients with recent-onset DCM. The aim of this study was to further investigate the effect of targeted antibiotic treatment of Bb-related recent-onset DCM in a larger cohort of patients.

PATIENTS AND METHODS:

We performed endomyocardial biopsy (EMB) in 110 individuals (53 ± 11 years, 34 women) with recent-onset unexplained DCM, and detected the Bb genome in 22 (20 %) subjects. Bb-positive patients were subsequently treated with intravenous ceftriaxone for 21 days in addition to conventional heart failure medication.

RESULTS:

At the 1-year follow-up, a significant improvement in left ventricular (LV) ejection fraction (26 ± 6  vs. 44 ± 12 %; p < 0.01) and a decrease in LV end-diastolic (69 ± 7 vs. 63 ± 11 mm; p < 0.01) and end-systolic (61 ± 9 vs. 52 ± 4 mm; p < 0.01) diameters were documented. Moreover, a significant improvement in heart failure symptoms (NYHA class 3.4 ± 0.6 vs. 1.5 ± 0.7; p < 0.01) was also observed.

CONCLUSION:

Targeted antibiotic treatment of Bb-related recent-onset DCM in addition to conventional heart failure therapy is associated with favorable cardiac remodeling and improvement of heart failure symptoms.

KEYWORDS:

Antibiotics; Borrelia burgdorferi; Dilated cardiomyopathy; Endomyocardial biopsy; Lyme disease

PMID:
25939436
DOI:
10.1007/s00059-015-4308-1
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center