Controlled Trial of Intravenous Immune Globulin in Recent-Onset Dilated Cardiomyopathy

McNamara, Dennis M.; Holubkov, Richard; Starling, Randall C.; Dec, G. William; Loh, Evan; Torre‐Amione, Guillermo; Gass, Alan; Janosko, Karen; Tokarczyk, Tammy; Kessler, Paul D.; Mann, Douglas L.; Feldman, Arthur M.

doi:10.1161/01.cir.103.18.2254

Cited by 519 publications

(291 citation statements)

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“…The longterm sequelae of viral myocarditis appear to be related to abnormal cellular and humoral immunity, many clinicians believe that immunosuppression should be beneWcial for myocarditis treatment, but has not shown to be eVective as conventional treatment for acute myocarditis [16,17]. Early trials of antiviral therapies, such as interferon, suggest a potential therapeutic role but require further investigation.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of lupus myocarditis in Korea

et al. 2007

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Clinically important myocarditis is an unusual feature in systemic lupus erythematosus (SLE). We describe the clinical characteristics, management and outcomes of Wve SLE patients who developed severe left ventricular dysfunction. Four patients were female with mean age of 36.4 years. Three patients had both lupus myocarditis and lupus nephritis. Four patients had raised anti-dsDNA antibody titer and low complement level and two patients had positive IgG anticardiolipin antibody. Three patients were treated by high-dose corticosteroids, one patient by intravenous pulse methylprednisolone, and one patient by intravenous immunoglobulin and pulse cyclophosphamide with high dose corticosteroids. Left ventricular function improved markedly in four patients and all of them had no recurrence of lupus myocarditis up to follow-up of 33 months. However, one patient, who showed no improvement of left ventricular function, was expired due to sudden cardiac arrest. Lupus myocarditis should be treated by immunosuppressive therapy with high-dose corticosteroids and mostly the prognosis might be good with early treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of lupus myocarditis in Korea

et al. 2007

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“…It can therefore be assumed that the optimal pharmacological treatment of heart failure according to guidelines can cause a positive effect in patients with ICM although this has not been convincingly demonstrated in a placebo-controlled study yet. In agreement with this, it was suggested that the increasing chance for LV function improvement in recent studies compared with older data was associated with advances in pharmacological therapy 42 . Also some experimental data as well as clinical studies confirm this.…”

Section: Discussionmentioning

confidence: 66%

Improvement of left ventricular systolic function in inflammatory cardiomyopathy: What plays a role?

Krejčí¹,

Hude²,

Ozábalová³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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, Lenka Spinarova aAims. To compare the differences between patients with inflammatory cardiomyopathy (ICM) with and without improvement in left ventricular (LV) systolic function and to identify the relevant predictors of LV improvement. Patients and Methods. The study included 63 patients with biopsy-proven ICM and heart failure symptoms of at least NYHA II, symptom duration ≤ 6 months, LV ejection fraction (LVEF) ≤ 40% assessed by echocardiography and presence of >14 mononuclear leukocytes (LCA+ cells)/mm 2 in biopsy samples. Patients were evaluated at baseline and after 6 months. Results. In the group with LVEF improvement of ≥ 10% (I+ group, n = 41), LVEF increased from 24 ± 7% to 47 ± 8% (P < 0.001). In 22 patients (group I-), there was no or minimal LVEF increase (< 10%). In the I+ group, there were more LCA+ cells/mm 2 at baseline (25.1 ± 16.5 vs. 18.5 ± 4.4 cells/mm 2 ; P = 0.032) and a more significant decrease in LCA+ cells in the follow-up (reduction of 13.6 ± 14.3 cells/mm 2 vs. 5.0 ± 7.7 cells/mm 2 in the I-group; P = 0.009). The univariate logistic regression showed a possible association of number of LCA+ cells, LV end-diastolic diameter and N-terminal fragment of pro-brain natriuretic peptide (NTproBNP) value with LVEF improvement. In the multivariate analysis, only NTproBNP at diagnosis was confirmed as an independent predictor of LVEF improvement (OR=1.2; 1.003 to 1.394; P = 0.046). Conclusion. The LV systolic function improvement was observed in 65% of the patients. In these patients, the number of inflammatory cells at baseline was higher and decreased more but the higher baseline NTproBNP value was the only independent predictor of LVEF improvement.

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“…39 In our previous study, exogenously administered IL-10, 15 or the gene transfer therapy of IL-10, 16 improved myocardial lesion in our model of viral myocarditis. In this study, gene expression of IL-10 in the heart was increased in mice treated with FLC, suggesting that a part of the effect of FLC might be attributable to this effect.…”

Section: Discussionmentioning

confidence: 68%