title: Reduction of morbidity by immunoadsorption therapy in patients with dilated cardiomyopathy.
abstract: BACKGROUND
  In patients with dilated cardiomyopathy (DCM) and severe congestive heart failure, immunoadsorption (IA) and subsequent IgG substitution leads to an acute and prolonged hemodynamic improvement. Goal of this study was to investigate the long-term effect of immunoadsorption on morbidity.
  
  
  METHODS
  In a retrospective analysis of 34 patients (17 patients who have received immunoadsorption therapy and 17 control patients) were included. Inclusion criteria were DCM, left ventricular ejection fraction less than 35%, NYHA classes II-III. The average time after immunoadsorption was 3.0 years (median 2.3 years). Both groups did not differ concerning sex, age, duration of disease, medication, baseline ejection fraction and NYHA class.
  
  
  RESULTS
  In patients who have received immunoadsorption (IA) the days of hospitalisation for congestive heart failure per year could be significantly reduced in contrast to the control patients (17.2 days prior to IA, 4.3 days after IA). Even if the procedural days for immunoadsorption were included there was still a significant reduction of hospitalisation if IA therapy was longer than 2.5 years ago. The days of hospitalisation increased gradually with time during the follow up period. IA induced an acute increase in EF (19.8-25.7%, p<0.01 vs. baseline).
  
  
  CONCLUSIONS
  IA not only leads to an acute hemodynamic improvement in patients with DCM but may also reduce morbidity in these patients during the next 3 years.
authors.affiliation: Medizinische Klinik der Charité, Humboldt-Universität zu Berlin, Schumannstr. 20/21, 10117 Berlin, Germany. fabian.knebel@charite.de
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.forename: Marco
authors.initials: M
authors.lastname: Böhm
authors.forename: Alexander
authors.initials: A
authors.lastname: Staudt
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
authors.forename: Mirko
authors.initials: M
authors.lastname: Tepper
authors.forename: Nicoline
authors.initials: N
authors.lastname: Jochmann
authors.forename: Klaus D
authors.initials: KD
authors.lastname: Wernicke
authors.forename: Stephan
authors.initials: S
authors.lastname: Felix
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology* / Q000628:therapy*; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007163:Immunosorbent Techniques; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D013995:Time
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D004077:Digoxin