Journal
CANADIAN JOURNAL OF CARDIOLOGY
Volume 24, Issue 7, Pages 571-574Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0828-282X(08)70638-X
Keywords
cardiomyopathies; dilated cardiomyopathy; heart failure; intravenous immunoglobulins; left ventricular dysfunction; myocarditis
Categories
Ask authors/readers for more resources
BACKGROUND: Although an autoimmune mechanism has been postulated for myocarditis and acute-onset inflammatory dilated cardiomyopathy (DCM), immunomodulatory treatment strategies are still under investigation. METHODS AND RESULTS: The clinical data of six patients with acute inflammatory DCM referred for evaluation for possible,heart transplantation were reviewed. All patients were admitted with acute congestive heart failure and severely impaired left ventricular (IV) function and were treated with high-dose (2 g/kg) intravenous immunoglobulin (IVIG). The diagnosis Of acute inflammatory DCM was based on recent onset of congestive heart failure (New York Heart Association functional class III or IV) with severely depressed LV ejection fraction ([LVEF] 30% or lower) occurring shortly after viral-like illness. All patients had inflammation on endomyocardial biopsy or elevated cardiac enzymes, as well as a normal coronary angiogram. All patients were in New York Heart Association class I or 11 at the time of hospital discharge. The mean LVEF improved from 21.7+/-7.5% at baseline to 50.3+/-8.6% at discharge (P=0.005). Four patients had complete recovery (LVEF 50% or higher) and two patients had partial IV recovery Patients were followed for a median 13.2 months (range two to 24 months) and had a mean LVEF of 53+/-6% (P not significant versus LVEF at discharge). CONCLUSIONS: Therapy with intravenous high-close IVIG may be a potentially useful treatment in selected patients if given early in the Course of acute fulminant inflammatory DCM. A randomized, prospective trial is warranted to prove the real benefit of IVIG in this patient population.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available