HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by ELLIS, R. W. Search for Related Content PubMed PubMed Citation Articles by ELLIS, R. W. Agricola Articles by ELLIS, R. W.

Infection and coronary heart disease

Department of Clinical Bacteriology, University Hospital NHS Trust, Queen Elizabeth Medical Centre, Edgbaston, Birmingham B15 2TH

Corresponding author: Dr R. W. Ellis.

Received September 6, 1996 Revision received November 19, 1996.
Accepted November 19, 1996

A large body of evidence exists that implicates a number of microbial agents in the pathogenesis of coronary heart disease (CHD). This, if proven, may have far-reaching implications for the prevention and treatment of CHD and other atherosclerotic disease. The histopathology of atherosclerosis and its natural history suggest infectious causation at many points along the progression of disease, particularly with regard to CHD, and a number of pathogens have been the focus of study. Viral agents implicated include Coxsackie B₄ virus, for which tenuous sero-epidemiological associations exist, and the Herpesviridae. The animal herpesvirus causing Marek's disease in chickens causes atherosclerotic lesions in these animals. Herpes simplex virus I and II have been found in aortic smooth muscle and produce changes in vitro in smooth muscle that are similar to those seen at the beginning of atherosclerosis and which may also explain some of the features of atherosclerotic complications. Cytomegalovirus is implicated more strongly sero-epidemiologically by in-vivo detection in atherosclerotic lesions and by its links with post-cardiac transplant vasculopathy - a syndrome similar to atherosclerosis. Bacteria have also been shown to have links with CHD. Chlamydia pneumoniae and Helicobacter pylori have both been associated sero-epidemiologically with CHD, and these findings have been consolidated by recent work showing their presence in atherosclerotic lesions in adults. Bacterial infections in general lead to many changes in lipid, thrombic and other acute-phase protein metabolism, and some of these changes occur with both C. pneumoniae and H. pylori infections. The ubiquity and similar epidemiological features to CHD of all these microbial pathogens make the resolution of the causative issue impossible by retrospective means. All that can be shown at present are a variety of weak and strong links, the significance of which can only be determined by large and perhaps lifetime prospective studies.

This article has been cited by other articles:

				S. Lai, J. A. C. Lima, H. Lai, D. Vlahov, D. Celentano, W. Tong, J. G. Bartlett, J. Margolick, and E. K. Fishman Human Immunodeficiency Virus 1 Infection, Cocaine, and Coronary Calcification Arch Intern Med, March 28, 2005; 165(6): 690 - 695. [Abstract] [Full Text] [PDF]

				S. V Pislaru, M. Van Ranst, C. Pislaru, Z. Szelid, G. Theilmeier, J.M Ossewaarde, P. Holvoet, S. Janssens, E. Verbeken, and F. J Van de Werf Chlamydia pneumoniae induces neointima formation in coronary arteries of normal pigs Cardiovasc Res, March 1, 2003; 57(3): 834 - 842. [Abstract] [Full Text] [PDF]

				J. Boman and M. R. Hammerschlag Chlamydia pneumoniae and Atherosclerosis: Critical Assessment of Diagnostic Methods and Relevance to Treatment Studies Clin. Microbiol. Rev., January 1, 2002; 15(1): 1 - 20. [Abstract] [Full Text]

				G. Barbaro, G. Barbarini, and A. M. Pellicelli HIV-Associated Coronary Arteritis in a Patient with Fatal Myocardial Infarction N. Engl. J. Med., June 7, 2001; 344(23): 1799 - 1800. [Full Text] [PDF]

				K. Okuda, K. Ishihara, T. Nakagawa, A. Hirayama, Y. Inayama, and K. Okuda Detection of Treponema denticola in Atherosclerotic Lesions J. Clin. Microbiol., March 1, 2001; 39(3): 1114 - 1117. [Abstract] [Full Text]

				S. F. Ameriso, E. A. Fridman, R. C. Leiguarda, G. E. Sevlever, and J. D. Spence Detection of Helicobacter pylori in Human Carotid Atherosclerotic Plaques Editorial Comment Stroke, February 1, 2001; 32(2): 385 - 391. [Abstract] [Full Text] [PDF]

				A. J. Dal Canto, H. W. Virgin IV, and S. H. Speck Ongoing Viral Replication Is Required for Gammaherpesvirus 68-Induced Vascular Damage J. Virol., December 1, 2000; 74(23): 11304 - 11310. [Abstract] [Full Text]

				D. G. Alber, K. L. Powell, P. Vallance, D. A. Goodwin, and C. Grahame-Clarke Herpesvirus Infection Accelerates Atherosclerosis in the Apolipoprotein E-Deficient Mouse Circulation, August 15, 2000; 102(7): 779 - 785. [Abstract] [Full Text] [PDF]

				J P Pell, J Sirel, A K Marsden, and S M Cobbe Seasonal variations in out of hospital cardiopulmonary arrest Heart, December 1, 1999; 82(6): 680 - 683. [Abstract] [Full Text]

				B. R. Dorn, W. A. Dunn Jr., and A. Progulske-Fox Invasion of Human Coronary Artery Cells by Periodontal Pathogens Infect. Immun., November 1, 1999; 67(11): 5792 - 5798. [Abstract] [Full Text] [PDF]

				M. Pahor, M. B. Elam, R. J. Garrison, S. B. Kritchevsky, and W. B. Applegate Emerging Noninvasive Biochemical Measures to Predict Cardiovascular Risk Arch Intern Med, February 8, 1999; 159(3): 237 - 245. [Abstract] [Full Text] [PDF]