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Potential role of humoral immunity in cardiac dysfunction of patients suffering from dilated cardiomyopathy

Alexander Staudt, MD^*,*, Yvonne Staudt, MD^*, Marcus Dörr, MD^*, Marco Böhm, MD, Fabian Knebel, MD, Astrid Hummel, MD^*, Lydia Wunderle, MD^*, Malte Tiburcy, MD^*, Klaus D. Wernecke, PhD, Gert Baumann, MD and Stephan B. Felix, MD^*

^* Klinik für Innere Medizin B, Ernst-Moritz-Arndt-Universität, Greifswald, Germany
Medizinische Klinik I, Charité, Humboldt-Universität, Berlin, Germany
Institut für Medizinische Biometrie, Charité, Humboldt-Universität, Berlin, Germany

View larger version (13K): [in a new window]   Figure 1 Individual effects of purified antibodies (IgG 300 mg/l) on isolated field-stimulated rat cardiomyocytes. Changes of Ca2+ transients (A) and systolic cell shortening (B) during superfusion (% changes from baseline): antibodies from plasma of healthy blood donors (controls, n = 45). Antibodies from dilated cardiomyopathy (DCM) patients that induced cardiodepressant effects (cardiodepressant group, n = 29). Antibodies from DCM patients that did not influence Ca2+ transients and systolic cell shortening (non-cardiodepressant group, n = 16). ###p < 0.001 significantly different from controls; +++p < 0.001 significantly different from non-cardiodepressant group.

View larger version (14K): [in a new window]   Figure 2 Changes in cardiac index in the cardiodepressant group (solid bars, n = 29) and in the non-cardiodepressant group (open bars, n = 16). ***p < 0.001 significantly different from baseline; +++p < 0.001 significantly different from non-cardiodepressant group. IA = immunoadsorption.

View larger version (13K): [in a new window]   Figure 3 Changes in stroke volume index in the cardiodepressant group (solid bars, n = 29) and in the non-cardiodepressant group (open bars, n = 16). ***p < 0.001 significantly different from baseline; +++p < 0.001 significantly different from non-cardiodepressant group. IA = immunoadsorption.

View larger version (15K): [in a new window]   Figure 4 Changes in systemic vascular resistance (SVR) in the cardiodepressant group (solid bars, n = 29)and in the non-cardiodepressant group (open bars, n = 16). ***p < 0.001 significantly different from baseline; +++p < 0.001 significantly different from non-cardiodepressant group. IA = immunoadsorption.

View larger version (10K): [in a new window]   Figure 5 Changes in LV ejection fraction as assessed by echocardiography in the cardiodepressant group (solid bars, n = 29) and in the non-cardiodepressant group (open bars, n = 16). ***p < 0.001 significantly different from baseline; ++p < 0.01 significantly different from non-cardiodepressant group. IA = immunoadsorption.