PMID- 27890513
OWN - NLM
STAT- MEDLINE
DCOM- 20170609
LR  - 20181202
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 69
IP  - 2
DP  - 2017 Feb
TI  - Therapeutic effect of immunoadsorption and subsequent immunoglobulin substitution 
      in patients with dilated cardiomyopathy: Results from the observational 
      prospective Bad Berka Registry.
PG  - 409-416
LID - S0914-5087(16)30161-7 [pii]
LID - 10.1016/j.jjcc.2016.07.014 [doi]
AB  - BACKGROUND: Elimination of cardiac autoantibodies, frequently detected in 
      patients with dilated cardiomyopathy (DCM), with immunoadsorption (IA) improves 
      functional capacity and left ventricular (LV) function. This study aimed to 
      prospectively address this issue in a large cohort of unselected patients. 
      METHODS: Consecutive patients undergoing IA followed by IgG substitution were 
      included. Clinical and echocardiographic parameters were assessed at baseline 
      (BL) and 12-month follow-up (FU). Patients were classified as IA responders when 
      >/=2 of the following criteria were achieved: improvement in the Minnesota Living 
      with Heart Failure Questionnaire (MLHFQ) >/=5 points, symptoms [>/=1 New York Heart 
      Association (NYHA) class], LV ejection fraction (EF) >/=10% or decrease in LV 
      end-diastolic diameter (EDD) >/=10%, or N-terminal pro B-type natriuretic peptide 
      (NT-pro-BNP) >/=50%. RESULTS: 93 patients (median age 61 years, LVEF 30%, duration 
      of symptoms 14 months, 87% in NYHA class III/IV, >90% treated with 
      beta-blocker/angiotensin-converting enzyme inhibitor) were included. When the entire 
      cohort was analyzed, a significant improvement in MLHFQ (50 vs. 26 points), 
      NYHA-class (median 3.0 vs. 2.0), LVEF (30% vs. 38%), LVEDD (62 vs. 59mm), 
      NT-pro-BNP (892 vs. 523pg/ml) was observed at FU (p<0.05 for all). 48% (n=43) 
      were classified as responders. Those were characterized by a shorter disease 
      duration (11 vs. 22 months), larger BL LVEDD (64 vs. 60mm), presence of >1 viral 
      genome, and higher values of mononuclear inflammatory cells at endomyocardial 
      biopsy. Sixteen (17.2%) patients experienced IA related complications. 
      CONCLUSIONS: A positive response is observed in 48% of inflammatory DCM patients 
      undergoing IA, and this translates into a significant improvement in clinical and 
      echocardiographic parameters.
CI  - Copyright (c) 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Ohlow, Marc-Alexander
AU  - Ohlow MA
AD  - Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany. Electronic 
      address: marc.ohlow@zentralklinik.de.
FAU - Brunelli, Michele
AU  - Brunelli M
AD  - Department of Invasive and Interventional Electrophysiology, Zentralklinik Bad 
      Berka, Germany.
FAU - Schreiber, Matthias
AU  - Schreiber M
AD  - Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
FAU - Lauer, Bernward
AU  - Lauer B
AD  - Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20161124
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Autoantibodies)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Autoantibodies/*metabolism
MH  - Cardiomyopathy, Dilated/*therapy
MH  - Cohort Studies
MH  - Diastole
MH  - Echocardiography
MH  - Female
MH  - Heart Ventricles/diagnostic imaging
MH  - Humans
MH  - Immunoglobulin G/*immunology
MH  - *Immunosorbent Techniques
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - *Quality of Life
MH  - Registries
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/therapy
OTO - NOTNLM
OT  - Dilated cardiomyopathy
OT  - Immunoadsorption
OT  - Inflammatory
OT  - Quality of life
EDAT- 2016/11/29 06:00
MHDA- 2017/06/10 06:00
CRDT- 2016/11/29 06:00
PHST- 2016/02/14 00:00 [received]
PHST- 2016/07/08 00:00 [revised]
PHST- 2016/07/22 00:00 [accepted]
PHST- 2016/11/29 06:00 [pubmed]
PHST- 2017/06/10 06:00 [medline]
PHST- 2016/11/29 06:00 [entrez]
AID - S0914-5087(16)30161-7 [pii]
AID - 10.1016/j.jjcc.2016.07.014 [doi]
PST - ppublish
SO  - J Cardiol. 2017 Feb;69(2):409-416. doi: 10.1016/j.jjcc.2016.07.014. Epub 2016 Nov 
      24.