Ig apheresis for the treatment of severe DCM patients

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• 作者：Sergey N. Pokrovsky^a ; ^{Dr.Pokrovsky@mail.ru} ; Marat V. Ezhov^a ; Maya S. Safarova^a ; Marina A. Saidova^a ; Viktor N. Shitov^a ; Marina I. Afanasieva^a ; Andrew I. Khaustov^b ; Irina Yu. Adamova^a ; Olga I. Afanasieva^a ; Gennady A. Konovalov^b
• 关键词：Dilated cardiomyopathy ; Ig apheresis ; Immunoadsorption ; Heart failure ; Cardiodepressive autoantibodies
• 刊名：Atherosclerosis, Supplements
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：14
• 期：1
• 页码：213-218
• 全文大小：369 K

文摘

Background

Autoantibodies against ¦Â1-adrenoreceptor (AR) are considered by many authors to be the most significant in autoimmune process during DCM. Immunoadsorption (IA) of immunoglobulins (Ig apheresis) is a logic approach to remove autoantibodies against?¦Â1-AR and other antibodies. The effect of Ig apheresis and the role of anti-¦Â1-AR in DCM are still an issue for discussion.

Methods

We have performed a prospective case-control study in 16 patients with DCM, NYHA Class II-IV congestive heart failure, positive and negative for anti-¦Â1-AR.

Results

We observed a clinically significant mean change of exercise tolerance compared with controls (6 MWT distance increased from 420?¡À?130?m to 550?¡À?150?m, p?<?0.05). Systolic function improved rapidly by increase in LVEF from 28.6?¡À?5.2 % to 33.0?¡À?10.3 % , LV end-systolic and end-diastolic volumes decreased from 166?¡À?58?mL to 148?¡À?50?mL and from 235?¡À?73?mL to 220?¡À?73?mL, respectively, whereas in the control group there was no significant change in clinical variables. The improved quality of life and cardiac function in apheresis group as well as negative changes in control group didn't correlate with the presence of anti-¦Â1-AR.

Conclusions

Ig apheresis for the treatment of DCM patients is associated with the improvement of quality of life and cardiac function regardless of the presence of anti-¦Â1-AR. We suggest that IgG apheresis is a safe and effective method for DCM patients.