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Hemodynamic effects of immunoadsorption and subsequent immunoglobulin substitution in dilated cardiomyopathy

Three-month results from a randomized study

Stephan B. Felix, MD^*, Alexander Staudt, MD^*, Wolf V. Dörffel, MD^*, Verena Stangl, MD^*, Kurt Merkel, MD, Manfred Pohl, PhD, Wolf D. Döcke, MD^||, Stanislao Morgera, MD, Hans H. Neumayer, MD, Klaus D. Wernecke, PhD^¶, Gerd Wallukat, PhD^#, Karl Stangl, MD^* and Gert Baumann, MD^*

^* 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

View larger version (13K): [in a new window]   Figure 1 Time schedule of immunoadsorption (IA) and cardiovascular monitoring; IA was performed in four courses until the third month.

View larger version (27K): [in a new window]   Figure 2 Changes in hemodynamics in the immunoadsorption/immunoglobulin group (IA/IgG group, filled bars, n = 9) and in the control group (controls, open bars, n = 9). (A) Cardiac index. (B) Stroke volume index. (C) Systemic vascular resistance. (D) Changes in left ventricular ejection fraction, as assessed by echocardiography. *p < 0.05; **p < 0.01 significantly different from baseline; +p < 0.05; ++p < 0.01 significantly different from controls.

View larger version (14K): [in a new window]   Figure 3 Changes in beta-receptor antibody level in the immunoadsorption/immunoglobulin group (IA/IgG group, filled bars, n = 9) and in the control group (controls, open bars, n = 9). *p < 0.05; **p < 0.01 significantly different from baseline; +p < 0.05; ++p < 0.01 significantly different from controls.