Serological Evidence for the Association of Bartonella henselae Infection with Arrhythmogenic Right Ventricular Cardiomyopathy

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an important cause of sudden death In young adults. On the basis of histopathologicat findings its pathogenesis may involve both a genetic origin and an inflammatory process. Bortonella henselae may cause endomyocarditis and was detected in myocardium from a young male who succumbed to sudden cardiac death. Hypothesis: We hypothesized that chronic infection with Bartonella henselae could contribute to the pathogenesis of ARVC. Methods: We investigated sera from 49 patients with ARVC for IgG antibodies to Bartonella henselae. In this study, 58 Swiss blood donors tested by the same method served as controls. Results: Six patients with ARVC (12%) had positive (>1:256) IgG titres in the immunofluorescence test with Bartonella henselae. In contrast, only 1 elevated titre was found in 58 controls (P <0.05). Interestingly, all patients with increased titres had no familial occurrence of ARVC. Conclusions: Further studies in larger patient cohorts seem justified to investigate a possible causal link between chronic Bortonella henselae and ARVC, in particular its sporadic (nonfamilial) form.