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IVIg Therapy for Patients With Idiopathic Cardiomyopathy and Endomyocardial Biopsy Proven High PVB19 Viral Load

Phase 1
Conditions
Heart Failure
Interventions
Drug: Intravenous immunoglobulin therapy
Registration Number
NCT00659386
Lead Sponsor
Maastricht University Medical Center
Brief Summary

Rationale: Parvovirus B19 (PVB19) persistence in the heart has been associated with progressive cardiac dysfunction and evolution to dilated cardiomyopathy.

Objective: Whether high dose of intravenous immunoglobulin (IVIg) in addition to conventional heart failure therapy achieves virus reduction, thereby resulting in improvement of cardiac function.

Study design: A interventional study of virus presence and cardiac functional capacity before and after IVIg therapy.

Study population: Patients with idiopathic cardiomyopathy and symptomatic heart failure for more than 1 year and a significant PVB19 viral load in endomyocardial biopsies (EMB) and treated with high dose of IVIg were included.

Intervention (if applicable): Patients were treated with a total dose of 2 g/kg of immune globulin administered as 0.5 g/kg IV over a period of 6 hours on each of 4 consecutive days.

Main study parameters/endpoints: EMBs: virus (PVB19, enteroviruses, adenoviruses, Epstein-Barr virus, human herpes virus-6 and cytomegalovirus), inflammation (lymphocytes an macrophages) and fibrosis. Cardiac functional capacity: NYHA classification, echocardiographic evaluation (left ventricular ejection fraction, end-systolic diameter, end-diastolic diameter).

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Idiopathic heart failure <1 year.
  • Optimal conventional heart failure medication <6 months.
  • PVB19 viral load >150copies/mcg DNA in EMBs.
Exclusion Criteria
  • significant (lesions >50% stenosis) coronary artery disease.
  • significant valvular disease.
  • systemic diseases such as sarcoidosis, giant cell myocarditis, hemochromatosis, or systemic autoimmune diseases.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AIntravenous immunoglobulin therapyPatients with chronic idiopathic cardiomyopathy and EMB proven high PVB19 virus load.
Primary Outcome Measures
NameTimeMethod
viral loads in EMBs before and after therapyAt baseline and 6 month follow-up
Secondary Outcome Measures
NameTimeMethod
Echocardiographic analysis, NYHA functional class, type/degree of inflammation and fibrosis in the myocardium.at baseline and at 6 month follow-up

Trial Locations

Locations (1)

University Hospital Maastricht

🇳🇱

Maastricht, Netherlands

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