Faculty Collaboration Database

Ig apheresis for the treatment of severe DCM patients. Atheroscler Suppl 2013 Jan;14(1):213-8

Date

01/30/2013

Pubmed ID

23357167

DOI

10.1016/j.atherosclerosissup.2012.10.028

Scopus ID

2-s2.0-84872858852 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

BACKGROUND: Autoantibodies against β1-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 β1-AR and other antibodies. The effect of Ig apheresis and the role of anti-β1-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-β1-AR.

RESULTS: We observed a clinically significant mean change of exercise tolerance compared with controls (6 MWT distance increased from 420 ± 130 m to 550 ± 150 m, p < 0.05). Systolic function improved rapidly by increase in LVEF from 28.6 ± 5.2% to 33.0 ± 10.3%, LV end-systolic and end-diastolic volumes decreased from 166 ± 58 mL to 148 ± 50 mL and from 235 ± 73 mL to 220 ± 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-β1-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-β1-AR. We suggest that IgG apheresis is a safe and effective method for DCM patients.

Author List

Pokrovsky SN, Ezhov MV, Safarova MS, Saidova MA, Shitov VN, Afanasieva MI, Khaustov AI, Adamova IY, Afanasieva OI, Konovalov GA

Author

Maya S. Safarova MD, PhD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Absorption
Adult
Autoantibodies
Autoimmunity
Biomarkers
Blood Component Removal
Cardiomyopathy, Dilated
Case-Control Studies
Exercise Tolerance
Female
Heart Failure
Humans
Immunosorbent Techniques
Immunosorbents
Male
Middle Aged
Prospective Studies
Quality of Life
Receptors, Adrenergic, beta-1
Recovery of Function
Russia
Stroke Volume
Systole
Time Factors
Treatment Outcome
Ventricular Function, Left