Complete elimination of cardiodepressant IgG3 autoantibodies by immunoadsorption in patients with severe heart failure

Akiyasu Baba, Makoto Akaishi, Megumi Shimada, Toshiaki Monkawa, Yasuhisa Wakabayashi, Michiko Takahashi, Yuji Nagatomo, Tsutomu Yoshikawa

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: Cardiodepressant IgG3 autoantibodies (CD-Abs) can be targeted by apheresis. Using blinded measurements of CD-Abs before and after immunoadsorption (IA), the cardiac function of patients who did or did not achieve complete CD-Abs elimination was compared. Methods and Results: Autoantibodies were completely removed from 18 patients with heart failure (New York Heart Assocation class 3 or 4, left ventricular ejection fraction (LVEF) <30%) using a selective IgG3 adsorption column. All patients had anti-β1-adrenergic and/or M2-muscarinic autoantibodies before IA, and all LVEF were measured on radionuclide ventriculography. CD-Abs were measured before and after IA, and patient status was blinded until all measurements were collected. Treatment was defined as complete when CD-Abs status changed from positive to negative after IA. Other instances were defined as incomplete. Six-min walk test results and brain natriuretic peptide levels improved significantly after IA (P<0.01). The increase in LVEF 3 months after IA was significantly greater after complete treatment in comparison to the incomplete treatment group (19±8-29±9% vs 18±9-17±8%, P<0.01). Cardiac insufficiency events were also more frequent in the incomplete treatment group. Conclusions: Complete elimination of CD-Abs with apheresis may be related to improved cardiac function in the treatment of heart failure.

Original languageEnglish
Pages (from-to)1372-1378
Number of pages7
JournalCirculation Journal
Volume74
Issue number7
DOIs
Publication statusPublished - 2010

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Autoantibodies
Heart Failure
Immunoglobulin G
Stroke Volume
Blood Component Removal
Radionuclide Ventriculography
Adrenergic Antagonists
Brain Natriuretic Peptide
Therapeutics
Treatment Failure
Cholinergic Agents
Adsorption

Keywords

  • Apheresis
  • Autoantibody
  • Heart failure
  • Immunoadsorption

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Complete elimination of cardiodepressant IgG3 autoantibodies by immunoadsorption in patients with severe heart failure. / Baba, Akiyasu; Akaishi, Makoto; Shimada, Megumi; Monkawa, Toshiaki; Wakabayashi, Yasuhisa; Takahashi, Michiko; Nagatomo, Yuji; Yoshikawa, Tsutomu.

In: Circulation Journal, Vol. 74, No. 7, 2010, p. 1372-1378.

Research output: Contribution to journalArticle

Baba, A, Akaishi, M, Shimada, M, Monkawa, T, Wakabayashi, Y, Takahashi, M, Nagatomo, Y & Yoshikawa, T 2010, 'Complete elimination of cardiodepressant IgG3 autoantibodies by immunoadsorption in patients with severe heart failure', Circulation Journal, vol. 74, no. 7, pp. 1372-1378. https://doi.org/10.1253/circj.CJ-09-0748
Baba, Akiyasu ; Akaishi, Makoto ; Shimada, Megumi ; Monkawa, Toshiaki ; Wakabayashi, Yasuhisa ; Takahashi, Michiko ; Nagatomo, Yuji ; Yoshikawa, Tsutomu. / Complete elimination of cardiodepressant IgG3 autoantibodies by immunoadsorption in patients with severe heart failure. In: Circulation Journal. 2010 ; Vol. 74, No. 7. pp. 1372-1378.
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