Effects of immunoadsorption and subsequent immunoglobulin G substitution on cardiopulmonary exercise capacity in patients with dilated cardiomyopathy
| Autor: | Wolfgang Hoffmann, Alexander Staudt, Arne Kieback, Christiane Trimpert, Daniel Beug, Ute Nauke, Stephan B. Felix, Fabian Knebel, Ralf Ewert, Lars R. Herda, Astrid Hummel, Martin Landsberger, Aniela Angelow, Marcus Dörr, Klaus Empen |
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| Rok vydání: | 2010 |
| Předmět: |
Cardiomyopathy
Dilated Male medicine.medical_specialty Ergometry Membrane transport and intracellular motility [NCMLS 5] Immunoglobulin G Pathogenesis Electrocardiography Oxygen Consumption Internal medicine Heart rate Medicine Humans In patient Immunoadsorption Immunosorbent Techniques Renal disorder [IGMD 9] Plethysmography Whole Body Heart Failure Ejection fraction Exercise Tolerance biology business.industry Dilated cardiomyopathy Stroke Volume Middle Aged Surface Plasmon Resonance medicine.disease Case-Control Studies Cardiology biology.protein Exercise Test Female Cardiology and Cardiovascular Medicine business Anaerobic exercise |
| Zdroj: | American Heart Journal, 159, 5, pp. 809-16 American Heart Journal, 159, 809-16 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2010.01.012 |
| Popis: | Item does not contain fulltext BACKGROUND: Recent data indicate that cardiac antibodies play an active role in the pathogenesis of dilated cardiomyopathy (DCM) and may contribute to cardiac dysfunction in patients with DCM. The present study investigated the influence of immunoadsorption with subsequent immunoglobulin G substitution (IA/IgG) on cardiopulmonary exercise capacity in patients with DCM. METHODS: Sixty patients with DCM (New York Heart Association II-IV, left ventricular ejection fraction < or =45%) were included in this single-center university hospital-based case-control study. Patients either were treated with IA/IgG (n = 30) or were followed without IA/IgG (n = 30). At baseline and after 3 months, we compared echocardiographic assessment of left ventricular function and spiroergometric exercise parameters. RESULTS: In contrast to controls, left ventricular ejection fraction improved significantly in the IA/IgG group from 33.0% +/- 1.2% to 40.1% +/- 1.5% (P < .001). In the control group, spiroergometric exercise parameters did not change during follow-up. After 3 months, maximum achieved power increased in the treatment group from 114.2 +/- 7.4 to 141.9 +/- 7.9 W (P = .02). Total exercise time increased in the treatment group from 812 +/- 29 to 919 +/- 30 seconds (P < .05). Peak oxygen uptake (Vo(2)) increased from 17.3 +/- 0.9 to 21.8 +/- 1.0 mL min(-1) kg(-1) after IA/IgG (P < .01). Oxygen pulse (peak Vo(2)/maximum heart rate) increased in the treatment group (10.7 +/- 0.7 vs 13.6 +/- 0.7 mL beat(-1) min(-1), P < .01). The Vo(2) at the gas exchange anaerobic threshold increased after 3 months in the treatment group from 10.3 +/- 0.5 to 13.2 +/- 0.5 mL min(-1) kg(-1) (P < .001). The ventilatory response to exercise (V(E)/Vco(2) slope) decreased after IA/IgG therapy from 32.3 +/- 1.5 to 28.7 +/- 0.9 (P = .02). CONCLUSIONS: In patients with DCM, IA/IgG therapy may induce improvement in echocardiographic and cardiopulmonary exercise parameters. 01 mei 2010 |
| Databáze: | OpenAIRE |
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