| Intravenous immunoglobulin treatment for acute fulminant inflammatory cardiomyopathy: series of six patients and review of literature. | |
| | |
MedLine Citation:
|
PMID: 18612500 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
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 (LV) 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 II 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 LV 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-dose 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:
|
Sorel Goland; Lawrence S C Czer; Robert J Siegel; Steven Tabak; Stanley Jordan; Daniel Luthringer; James Mirocha; Bernice Coleman; Robert M Kass; Alfredo Trento |
Publication Detail:
|
Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Canadian journal of cardiology Volume: 24 ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2008 Jul |
Date Detail:
|
Created Date: 2008-07-09 Completed Date: 2008-07-22 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada |
Other Details:
|
Languages: eng Pagination: 571-4 Citation Subset: IM |
Affiliation:
|
Division of Cardiology, Universigy of California, Los Angeles, CA 90048, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Adult Biopsy Coronary Angiography Diagnosis, Differential Female Follow-Up Studies Heart Failure / diagnosis, etiology*, surgery Heart Transplantation Humans Immunoglobulins, Intravenous / therapeutic use* Immunologic Factors / therapeutic use* Male Middle Aged Myocarditis / complications, diagnosis, drug therapy* Myocardium / pathology Retrospective Studies Ventricular Dysfunction, Left / etiology*, surgery |
| Chemical | |
Reg. No./Substance:
|
0/Immunoglobulins, Intravenous; 0/Immunologic Factors |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Enhancing hypertension awareness and management in the elderly: lessons learned from the Airdrie Com...
Next Document: Prevalence of cardiometabolic risk factors by weight status in a population-based sample of Quebec c...