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More than half of the patients with acute Puumala hantavirus infection have abnormal cardiac findings.

Research paper by Satu S Makela, Liisa L Kokkonen, Ilpo I Ala-Houhala, Kaj K Groundstroem, Aimo A Harmoinen, Heini H Huhtala, Mikko M Hurme, Antti A Paakkala, Ilkka I Porsti, Vesa V Virtanen, Antti A Vaheri, Jukka J Mustonen

Indexed on: 22 Oct '08Published on: 22 Oct '08Published in: Scandinavian journal of infectious diseases



Abstract

This study was conducted to determine the frequency, severity and outcome of cardiac findings in patients with acute Puumala hantavirus-induced nephropathia epidemica (NE). 70 consecutive, hospital-treated patients with serologically confirmed NE were prospectively examined using serial electrocardiograms (ECG), plasma troponin I, tumour necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and echocardiography (ECHO). Examinations were repeated after 3 and 12 months. ECG changes were observed in 57% of patients. Plasma troponin I levels remained normal in all. In six patients, ECHO showed left ventricular contraction abnormalities, and 1 patient had mild pericardial effusion. There were no differences in clinical or standard laboratory findings or in plasma TNF-alpha and IL-6 concentrations between patients with and without ECG or ECHO changes. During the follow-up, all acute-phase changes in ECG and ECHO reverted to normal, which probably reflects their benign nature. We conclude that abnormal cardiac findings are surprisingly common during NE.