Clinical examination about immunoadsorption therapy for dilated cardiomyopathy
- Conditions
- dilated cardiomyopathy
- Registration Number
- JPRN-UMIN000000623
- Lead Sponsor
- Department of Cardiology, Kitasato Institute Hospital
- Brief Summary
Background: Cardiodepressant IgG3 autoantibodies (CD-Abs) can be targeted by apheresis. Using blinded measurements of CD-Abs before and after immunoadsorption (IA), the cardiac function of patients who did or did not achieve complete CD-Abs elimination was compared. Methods and Results: Autoantibodies were completely removed from 18 patients with heart failure (New York Heart Assocation class 3 or 4, left ventricular ejection fraction (LVEF) <30%) using a selective IgG3 adsorption column. All patients had anti-beta1-adrenergic and/or M2-muscarinic autoantibodies before IA, and all LVEF were measured on radionuclide ventriculography. CD-Abs were measured before and after IA, and patient status was blinded until all measurements were collected. Treatment was defined as complete when CD-Abs status changed from positive to negative after IA. Other instances were defined as incomplete. Six-min walk test results and brain natriuretic peptide levels improved significantly after IA (P<0.01). The increase in LVEF 3 months after IA was significantly greater after complete treatment in comparison to the incomplete treatment group (19+-8 to 29+-9% vs 18+-9 to 17+-8%, P<0.01). Cardiac insufficiency events were also more frequent in the incomplete treatment group. Conclusions: Complete elimination of CD-Abs with apheresis may be related to improved cardiac function in the treatment of heart failure.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete: follow-up complete
- Sex
- All
- Target Recruitment
- 20
Not provided
On ACE inhibitors, With known heart basal diseases, Acute myocarditis, Active infectious disease (including viral hepatitis), Neoplasm, Excess alcoholic damages on liver or heart, Pregnancy.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Changes of body weight, 6 minutes walking test, cardio-thoracic ratio, echocardiographic parameters, left ventricular ejection fraction, and plasma BNP level after 3-5 immunoadsorption therapies (10-20days).
- Secondary Outcome Measures
Name Time Method Presence of side effect during 3-5 immunoadsorption therapies (10-20days).