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| |  Heart Abnormalities Observed in Children With Respiratory Syncytial Virus Infection: Presented at ICAAC By Ed Susman SAN FRANCISCO -- September 18, 2009 -- Children infected with respiratory syncytial virus (RSV) should be monitored for cardiac abnormalities, according to a study presented here at the 49th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). The study detected significantly more heart problems in children with the virus when compared with children not infected with the pathogen. “These results highlight that respiratory syncytial virus seems to play a direct role in the determination of heart damage during infection,” said Susanna Esposito, MD, University of Milan, Milan, Italy, on September 14. However, Dr. Esposito said that within 4 weeks following treatment for the infection the heart abnormalities appeared to resolve spontaneously. Even so, the study suggests that heart evaluation has to be performed in all the children with RSV bronchiolitis. Dr. Esposito and colleagues analysed 74 infants aged less than 1 year (mean age, 6 months; 25 boys), who were hospitalised for bronchiolitis during the winter seasons 2007-2008 and 2008-2009. At admission, clinicians acquired a nasopharyngeal aspirate from each child to be tested for RSV infection. They also drew blood to test for troponin levels and were fitted with a 24-hour Holter electrocardiogram monitor. The children also underwent echocardiography. The medical conditions and Holter examinations of each patient were re-evaluated 2 and 4 weeks later. A total of 35 children had evidence of RSV infection. When these children were compared with other children without RSV infection, the researchers found that 20% of the RSV-infected children had pathologic cardiac arrhythmias compared with 2.6% of the other group of infants. The difference was statistically significant (P = .02). She also found that about 74.3% of the children infected with the virus experienced abnormal heart rate variability during the day compared with 35.9% of children without the infection (P = .0002). The researchers did not observe differences in cardiac troponin I, pulse oximetry or chest radiography between the 2 groups of patients. Dr. Esposito noted that heart involvement appeared related to the respiratory syncytial viral load. If the child had a viral load in excess of 100,000 copies/mL, the child was more likely to develop the cardiac abnormalities. However, the severity of disease or use of medications did not seem to impact cardiac parameters. “Findings of this study show that heart damage is common in bronchiolitis due to respiratory syncytial virus infection and seems due to a direct role of viral replication, and are useful for improving the monitoring of infants with respiratory syncytial virus bronchiolitis during hospitalisation and for understanding the importance of prevention,” said Dr. Esposito. [Presentation title: Respiratory Syncytial Virus (RSV) and Heart Damage. Abstract G1-1540]
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