Herpesvirus infection and thoracic aortic aneurysm: Synthesis of evidence and contradictions

doi:10.4330/wjc.122814

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Publication Name

World Journal of Cardiology

ISSN

1949-8462

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Cardiol. Jul 26, 2026; 18(7): 122814
Published online Jul 26, 2026. doi: 10.4330/wjc.122814

Herpesvirus infection and thoracic aortic aneurysm: Synthesis of evidence and contradictions

Andrey V Suslov, Zukhra B Khasanova, Anton S Buchaka, Aleksandr D Doroschuk, Anton Yu Postnov

Andrey V Suslov, Zukhra B Khasanova, Aleksandr D Doroschuk, Anton Yu Postnov, Laboratory of Cardiovascular Pathomorphology, National Medical Research Center of Cardiology (Academician E.I. Chazov), Moscow 121552, Russia

Anton S Buchaka, Anton Yu Postnov, Laboratory of Cellular and Molecular Cardiovascular Pathology, Petrovsky National Research Center of Surgery, Moscow 119991, Russia

Author contributions: Suslov AV designed the study, analyzed the data, wrote the manuscript and performed statistical analysis; Khasanova ZB performed the PCR analysis and contributed to data interpretation; Buchaka AS performed the histological and immunohistochemical analysis; Doroschuk AD participated in tissue sample processing and wrote the manuscript; Postnov AY designed the study, analyzed the data and acquired funding; all authors have read and approved the final manuscript.

AI contribution statement: AI tools (specifically DeepSeek, version 202503) were used solely for grammar and punctuation checking, as well as for language polishing of the manuscript. No AI tool was involved in study design, data collection, data analysis, interpretation of results, or formulation of conclusions. All the AIgenerated suggestions were critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.

Supported by the Ministry of Health of the Russian Federation, State Assignment to the National Medical Research Center of Cardiology (Academician E.I. Chazov), No. 124020100084-4.

Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Petrovsky National Research Center of Surgery (Approval No. 3).

Informed consent statement: The requirement for written informed consent was waived by the Institutional Review Board due to the retrospective nature of the study and the use of anonymized tissue samples.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The author stated that the data of this study can be obtained by contacting the corresponding author under reasonable circumstances.

Corresponding author: Andrey V Suslov, Research Fellow, Laboratory of Cardiovascular Pathomorphology, National Medical Research Center of Cardiology (Academician E.I. Chazov), 15A Ulitsa Akademika Chazova, Moscow 121552, Russia. dr_suslov@mail.ru

Received: April 29, 2026
Revised: June 16, 2026
Accepted: July 7, 2026
Published online: July 26, 2026
Processing time: 80 Days and 3.4 Hours

Abstract

BACKGROUND

Several studies have detected viruses in blood vessel walls of patients with aneurysms; however, the role played by this association in the pathogenesis of thoracic aortic aneurysm (TAA) has not been systematically investigated.

AIM

To evaluate whether herpesvirus infection is associated with TAA.

METHODS

We performed a retrospective study of 43 patients with TAA (25 patients with non-dissecting TAA; 18 patients with dissecting TAA). Aortic tissue samples were analyzed to detect viral proteins [herpes simplex virus type 1, herpes simplex virus type 2, cytomegalovirus, and Epstein-Barr virus (EBV)] by immunohistochemistry or viral DNA by real-time PCR. Inflammatory infiltrates were characterized with CD4 and CD68 antibodies. Descriptive statistics, hypothesis testing, and linear modeling were performed using base R functions.

RESULTS

Immunohistochemical analysis detected no viral proteins in any of the 43 samples. PCR detected EBV DNA in only one patient (1/43, 2.3%), who was in the dissection group (1/18, 5.6%). Inflammatory infiltrates in the dissection group consisted predominantly of CD4⁺ T cells and CD68⁺ macrophages. Statistically significant intergroup differences in neither age nor sex were observed (P = 0.385).

CONCLUSION

The presence of the virus suggests that herpesvirus infection and TAA can coexist. Our findings do not support a causal relationship between herpesvirus infection and TAA in this cohort, and further larger prospective studies need to be conducted.

Keywords: Thoracic aortic aneurysm; Aortic dissection; Herpesvirus infection; Inflammation; Pathogenesis

Core Tip: In this study, Epstein-Barr virus DNA was detected in only one patient with aortic dissection (5.6%). Inflammatory infiltrates in the dissection group consisted predominantly of CD4⁺ T cells and CD68⁺ macrophages. Our findings do not support a causal relationship between herpesvirus infection and thoracic aortic aneurysm in this cohort.