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

研究成果: Article査読

38 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)1372-1378
ページ数7
ジャーナルCirculation Journal
74
7
DOI
出版ステータスPublished - 2010

ASJC Scopus subject areas

  • 循環器および心血管医学

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