RNA Virus Gene Signatures Detected in Patients With Cardiomyopathy After Chemotherapy; A Pilot Study.

Abstract

Background:

Viral infections are pervasive and leading causes of myocarditis. Immune-suppression after chemotherapy increases opportunistic infections, but the incidence of virus-induced myocarditis is unknown.

Objective:

An unbiased, blinded screening for RNA viruses was performed after chemotherapy with correlation to cardiac function.

Methods:

High-throughput sequencing of RNA isolated from blood samples was analyzed following chemotherapy for hematological malignancies (N = 28) and compared with left ventricular ejection fraction (LVEF).

Results:

On initial rigorous analysis, low levels of influenza orthomyxovirus and avian paramyxovirus sequences were detectable, but without significant correlation to LVEF (r = 0.208). A secondary broad data mining analysis for virus sequences, without filtering human sequences, detected significant correlations for paramyxovirus with LVEF after chemotherapy (r = 0.592, P < 0.0096). Correlations were similar for LVEF pre- and post- chemotherapy for orthomyxovirus (R = 0.483, P < 0.0421). Retrovirus detection also correlated with LVEF post (r = 0.453, p < 0.0591), but not pre-chemotherapy, but is suspect due to potential host contamination. Detectable phage and anellovirus had no correlation. Combined sequence reads (all viruses) demonstrated significant correlation (r = 0.621, P < 0.0078). Reduced LVEF was not associated with chemotherapy (P = NS).

Conclusions:

This is the first report of RNA virus screening in circulating blood and association with changes in cardiac function among patients post chemotherapy, using unbiased, blinded, high-throughput sequencing. Influenza orthomyxovirus, avian paramyxovirus and retrovirus sequences were detectable in patients with reduced LVEF. Further analysis for RNA virus infections in patients with cardiomyopathy after chemotherapy is warranted.

• Authors: Kyle Varkoly, Shaoyuan Tan, Roxana Beladi, David Fonseca, Isabela Rivabem Zanetti, Simona Kraberger, Chintan Shah, Jordan R Yaron, Liqiang Zhang, Michael Juby, Ayman Fath, Sriram Ambadapadi, Melanie House, Paul Maranian, Carl J Pepine, Arvind Varsani, Jan Moreb, Stacey Schultz-Cherry, Alexandra R Lucas
• Journal: Frontiers in cardiovascular medicine (Front Cardiovasc Med) Vol. 9 Pg. 821162 ( 2022) ISSN: 2297-055X [Print] Switzerland
• PMID: 35360008 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Varkoly, Tan, Beladi, Fonseca, Zanetti, Kraberger, Shah, Yaron, Zhang, Juby, Fath, Ambadapadi, House, Maranian, Pepine, Varsani, Moreb, Schultz-Cherry and Lucas.