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(Circulation. 1999;99:879-882.)
© 1999 American Heart Association, Inc.

Clinical Investigation and Reports

Detection of Chlamydia pneumoniae But Not Cytomegalovirus in Occluded Saphenous Vein Coronary Artery Bypass Grafts

Claus Bartels, MD; Matthias Maass, MD; Gregor Bein, MD; Rainer Malisius, MD; Nicole Brill; J. F. Matthias Bechtel, MD; Friedhelm Sayk; Alfred C. Feller, MD; Hans-Hinrich Sievers, MD

From the Clinic for Cardiac Surgery, Institute of Medical Microbiology (M.M.), Institute of Pathology (R.M., A.C.F.), University of Luebeck, Luebeck, Germany.

Correspondence to C. Bartels, MD, Clinic for Cardiac Surgery, Medical University Lübeck, Ratzeburger Allee 160, 23538 Lübeck, FRG.

Background—A causal relation between atherosclerosis and chronic infection with Chlamydia pneumoniae and/or cytomegalovirus (CMV) has been suggested. Whether the unresolved problem of venous coronary artery bypass graft occlusion is related to infection with C pneumoniae and/or CMV has not been addressed.

Methods and Results—Thirty-eight occluded coronary artery vein grafts and 20 native saphenous veins were examined. Detection of C pneumoniae DNA was performed by use of nested polymerase chain reaction (PCR). Homogenisates from the specimen were cultured for identification of viable C pneumoniae. Both conventional PCR and quantitative PCR for detection of CMV DNA were applied. Differential pathological changes (degree of inflammation, smooth muscle cell proliferation [MIB-1]) were determined and correlated to the detection of both microorganisms. C pneumoniae DNA could be detected in 25% of occluded vein grafts. Viable C pneumoniae was recovered from 16% of occluded vein grafts. Except for 1 native saphenous vein, all control vessels were negative for both C pneumoniae detection and culture. All pathological and control specimens were negative for CMV DNA detection. Pathological changes did not correlate with C pneumoniae detection.

Conclusions—Occluded aorto-coronary venous grafts harbor C pneumoniae but not CMV. The detection of C pneumoniae in occluded vein grafts warrants further investigation.

Key Words: viruses • bypass • atherosclerosis • coronary disease

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