| Intravenous immunoglobulin therapy for patients with idiopathic cardiomyopathy and endomyocardial biopsy-proven high PVB19 viral load. | |
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MedLine Citation:
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PMID: 20386074 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Parvovirus B19 (PVB19) persistence in the heart has been associated with progressive cardiac dysfunction and evolution to dilated cardiomyopathy. In the present study, we investigated whether immunomodulation with intravenous immunoglobulin (IVIg) in addition to conventional heart failure therapy is safe and achieves virus reduction. Such therapy might improve cardiac function in patients with chronic dilated cardiomyopathy (DCM) and a significant PVB19 viral load in the heart. METHODS: PVB19 viral load was studied in 25 post-mortem cardiac samples of patients with a normal heart. Then, 17 consecutive patients (mean age 53 +/-3 years) with DCM and symptomatic heart failure for >1 year with a PVB19 viral load in endomyocardial biopsies of >250 copies/microg DNA were treated with a high dose of IVIg (2 g/kg). RESULTS: The post-mortem cardiac samples revealed a PVB19 presence in 80% with a mean load of 131 +/-40 copies/microg DNA. In the treated patients, IVIg resulted in a significant decrease of PVB19 viral load from 1,420 +/-216 to 619 +/-200 copies/microg DNA (P=0.004) and significantly improved the ejection fraction from 33 +/-3% 6 months before treatment and 34 +/-3% at baseline to 41 +/-3% 6 months (P=0.001) after IVIg therapy. The New York Heart Association classification significantly improved from 2.5 +/-0.1 at baseline to 2.1 +/-0.1 at follow-up (P=0.004). No therapy-related complications were noted. CONCLUSIONS: The present pilot study demonstrates that IVIg significantly reduces viral load and improves cardiac function in patients with DCM related to increased PVB19 viral load in the heart. |
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Authors:
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Robert Dennert; Sebastiaan Velthuis; Simon Schalla; Luc Eurlings; Robert-Jan van Suylen; Pieter van Paassen; Jan William Cohen Tervaert; Petra Wolffs; Valàre J Goossens; Catrien Bruggeman; Johannes Waltenberger; Harry J Crijns; Stephane Heymans |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Antiviral therapy Volume: 15 ISSN: 2040-2058 ISO Abbreviation: Antivir. Ther. (Lond.) Publication Date: 2010 |
Date Detail:
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Created Date: 2010-04-13 Completed Date: 2010-07-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9815705 Medline TA: Antivir Ther Country: England |
Other Details:
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Languages: eng Pagination: 193-201 Citation Subset: IM |
Affiliation:
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Department of Cardiology, CARIM, University Hospital Maastricht, Maastricht, the Netherlands. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00659386 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Biopsy Cardiomyopathy, Dilated / complications, etiology, therapy*, virology DNA, Viral / analysis, isolation & purification Female Heart / physiopathology, virology Heart Failure / etiology, therapy Humans Immunoglobulins, Intravenous / therapeutic use* Immunologic Factors / therapeutic use* Male Middle Aged Myocarditis / drug therapy, etiology, therapy, virology Myocardium / pathology Parvoviridae Infections / complications, therapy*, virology Parvovirus B19, Human / genetics, isolation & purification, physiology* Pilot Projects Sequence Analysis, DNA Treatment Outcome Viral Load* |
| Chemical | |
Reg. No./Substance:
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0/DNA, Viral; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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