|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2000; 35:1590-1598 © 2000 by the American College of Cardiology Foundation |
* Medizinische Klinik, Kardiologie Medizinische Klinik, Nephrologie Charité, Humboldt-Universtät zu Berlin, Berlin-Buch, Germany
Institut für Pathologie und Dermatohistologie, Diagnostisches Zentrum Berlin, Berlin-Buch, Germany
Institut für Medizinische Biophysik, Berlin-Buch, Germany
|| Immunologie, Berlin-Buch, Germany und
¶ Biometrie, Charité, Humboldt-Universtät zu Berlin, Berlin-Buch, Germany
# Max Delbrück Zentrum für Molekulare Medizin, Berlin-Buch, Germany
Manuscript received June 24, 1999; revised manuscript received November 11, 1999, accepted January 7, 2000.
Reprint requests and correspondence: Dr. Stephan B. Felix, Medizinische Klinik und Poliklinik Charité, Kardiologie, Campus Mitte, Humboldt-Universität zu Berlin, Schumannstr. 20-21, D-10098 Berlin, Germany
stephan.felix{at}charite.de
OBJECTIVES
The objective of our study was to assess the hemodynamic effects of immunoadsorption (IA) and subsequent immunoglobulin G (IgG) substitution in comparison with the effects of conventional medical treatment in patients with dilated cardiomyopathy (DCM).
BACKGROUND
Various circulating cardiac autoantibodies have been detected among patients suffering from DCM. These antibodies are extractable by IA.
METHODS
Patients with DCM (n = 18, New York Heart Association III–IV, left ventricular ejection fraction <30%) and who were on stable medication participated in the study. Hemodynamic measurements were performed using a Swan-Ganz thermodilution catheter. The patients were randomly assigned either to the treatment group with IA and subsequent IgG substitution (IA/IgG group, n = 9) or to the control group without IA/IgG (n = 9). In the IA/IgG group, the patients were initially treated in one IA session daily on three consecutive days. After the final IA session, 0.5 g/kg of polyclonal IgG was substituted. At one-month intervals, IA was then repeated for three further courses with one IA session daily on two consecutive days, until the third month.
RESULTS
After the first IA course and IgG substitution, cardiac index (CI) increased from 2.1 (±0.1) to 2.8 (±0.1) L/min/m2 (p < 0.01) and stroke volume index (SVI) increased from 27.8 (±2.3) to 36.2 (±2.5) ml/m2 (p < 0.01). Systemic vascular resistance (SVR) decreased from 1,428 (±74) to 997 (±55) dyne·s·cm–5 (p < 0.01). The improvement in CI, SVI and SVR persisted after three months. In contrast, hemodynamics did not change throughout the three months in the control group.
CONCLUSIONS
Immunoadsorption and subsequent IgG substitution improves cardiovascular function in DCM.
| ||||||||||||||||||||||||||||||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  F. Leuschner, J. Li, S. Goser, L. Reinhardt, R. Ottl, P. Bride, J. Zehelein, G. Pfitzer, A. Remppis, E. Giannitsis, et al. Absence of auto-antibodies against cardiac troponin I predicts improvement of left ventricular function after acute myocardial infarction Eur. Heart J., August 2, 2008; 29(16): 1949 - 1955. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. H. Medei, J. H.M. Nascimento, R. C. Pedrosa, L. Barcellos, M. O. Masuda, S. Sicouri, M. V. Elizari, and A. C. Campos de Carvalho Antibodies with beta-adrenergic activity from chronic chagasic patients modulate the QT interval and M cell action potential duration Europace, July 1, 2008; 10(7): 868 - 876. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Tutor, P. Penela, and F. Mayor Jr. Anti-{beta}1-adrenergic receptor autoantibodies are potent stimulators of the ERK1/2 pathway in cardiac cells Cardiovasc Res, October 1, 2007; 76(1): 51 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Okazaki and T. Honjo PD-1 and PD-1 ligands: from discovery to clinical application Int. Immunol., July 2, 2007; (2007) dxm057v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Staudt, P. Eichler, C. Trimpert, S. B. Felix, and A. Greinacher Fc{gamma} Receptors IIa on Cardiomyocytes and Their Potential Functional Relevance in Dilated Cardiomyopathy J. Am. Coll. Cardiol., April 24, 2007; 49(16): 1684 - 1692. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Magnani and G. W. Dec Myocarditis: Current Trends in Diagnosis and Treatment Circulation, February 14, 2006; 113(6): 876 - 890. [Full Text] [PDF]
|
|
|
|
|
|
A. Staudt, Y. Staudt, M. Dorr, M. Bohm, F. Knebel, A. Hummel, L. Wunderle, M. Tiburcy, K. D. Wernecke, G. Baumann, et al. Potential role of humoral immunity in cardiac dysfunction of patients suffering from dilated cardiomyopathy J. Am. Coll. Cardiol., August 18, 2004; 44(4): 829 - 836. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Bohm, T Dorner, F Knebel, A Bruns, N Jochmann, and G Baumann Longlasting effects of immunoadsorption in severe Sjogren's syndrome Ann Rheum Dis, February 1, 2004; 63(2): 214 - 215. [Full Text] [PDF]
|
|
|
|
|
|
J. W Mason Myocarditis and dilated cardiomyopathy: An inflammatory link Cardiovasc Res, October 15, 2003; 60(1): 5 - 10. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.B. Felix, A. Staudt, and G. Baumann Immunoadsorption as a new therapeutic principle for treatment of dilated cardiomyopathy Eur. Heart J. Suppl., December 1, 2002; 4(suppl_I): I63 - I68. [Abstract] [PDF]
|
|
|
|
|
|
A. Staudt, M. Bohm, F. Knebel, Y. Grosse, C. Bischoff, A. Hummel, J. B. Dahm, A. Borges, N. Jochmann, K. D. Wernecke, et al. Potential Role of Autoantibodies Belonging to the Immunoglobulin G-3 Subclass in Cardiac Dysfunction Among Patients With Dilated Cardiomyopathy Circulation, November 5, 2002; 106(19): 2448 - 2453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hjalmarson, M. Fu, and R. Mobini Who are the enemies? Inflammation and autoimmune mechanisms Eur. Heart J. Suppl., November 1, 2002; 4(suppl_G): G27 - G32. [Abstract] [PDF]
|
|
|
|
|
|
S. B. Felix, A. Staudt, M. Landsberger, Y. Grosse, V. Stangl, T. Spielhagen, G. Wallukat, K. D. Wernecke, G. Baumann, and K. Stangl Removal of cardiodepressant antibodies in dilated cardiomyopathy by immunoadsorption J. Am. Coll. Cardiol., February 20, 2002; 39(4): 646 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Kishimoto, H. Takada, H. Kawamata, M. Umatake, and H. Ochiai Immunoglobulin Treatment Prevents Congestive Heart Failure in Murine Encephalomyocarditis Viral Myocarditis Associated with Reduction of Inflammatory Cytokines J. Pharmacol. Exp. Ther., November 1, 2001; 299(2): 645 - 651. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. P. Liu and J. W. Mason Advances in the Understanding of Myocarditis Circulation, August 28, 2001; 104(9): 1076 - 1082. [Full Text] [PDF]
|
|
|
|
|
|
I. Schimke, J. Muller, F. Priem, I. Kruse, B. Schon, J. Stein, R. Kunze, G. Wallukat, and R. Hetzer Decreased oxidative stress in patients with idiopathic dilated cardiomyopathy one year after immunoglobulin adsorption J. Am. Coll. Cardiol., July 1, 2001; 38(1): 178 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Mann Autoimmunity, immunoglobulin adsorption and dilated cardiomyopathy: has the time come for randomized clinical trials? J. Am. Coll. Cardiol., July 1, 2001; 38(1): 184 - 186. [Full Text] [PDF]
|
|
|
|
|
|
A. Staudt, F. Schaper, V. Stangl, A. Plagemann, M. Bohm, K. Merkel, G. Wallukat, K. D. Wernecke, K. Stangl, G. Baumann, et al. Immunohistological Changes in Dilated Cardiomyopathy Induced by Immunoadsorption Therapy and Subsequent Immunoglobulin Substitution Circulation, June 5, 2001; 103(22): 2681 - 2686. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Chiale, I. Ferrari, E. Mahler, M. A. Vallazza, M. V. Elizari, M. B. Rosenbaum, and M. J. Levin Differential Profile and Biochemical Effects of Antiautonomic Membrane Receptor Antibodies in Ventricular Arrhythmias and Sinus Node Dysfunction Circulation, April 3, 2001; 103(13): 1765 - 1771. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kishimoto, N. Takamatsu, H. Kawamata, H. Shinohara, and H. Ochiai Immunoglobulin treatment ameliorates murine myocarditis associated with reduction of neurohumoral activity and improvement of extracellular matrix change J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1979 - 1984. [Abstract] [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
