title: Therapeutic plasma exchange a potential strategy for patients with advanced heart failure.
abstract: BACKGROUND
  Previous reports had emphasized the importance of humoral immunity in heart failure in humans, primarily determined by the presence of circulating antibodies. However, there is little or no information about the frequency of anticardiac antibodies present in failing human myocardium.
  
  
  METHODS
  Clinical data and myocardial tissue samples were analyzed to determine the role of humoral immunity in patients with chronic heart failure (CHF) in different SETTINGS.
  
  
  RESULTS
  Anticardiac antibodies were found present in failing hearts but not in normal control hearts. Further, the level of expression of these anticardiac antibodies changed with the severity of the disease state; and in patients with acute heart failure, we found selective activation of B cells. Finally, treatment of CHF patients with therapeutic plasma exchange, a strategy that removes circulating antibodies, resulted in a reduction in anticardiac antibody deposition and improvements in cardiac function.
  
  
  CONCLUSIONS
  These data collectively suggest a role of humoral immunity in the progression of heart failure.
authors.affiliation: Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas, USA. gtorre@tmhs.org
authors.forename: Guillermo
authors.initials: G
authors.lastname: Torre-Amione
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Orrego
authors.forename: Nashwa
authors.initials: N
authors.lastname: Khalil
authors.forename: Christian
authors.initials: C
authors.lastname: Kottner-Assad
authors.forename: Christopher
authors.initials: C
authors.lastname: Leveque
authors.forename: Rene
authors.initials: R
authors.lastname: Celis
authors.forename: Keith A
authors.initials: KA
authors.lastname: Youker
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Estep
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000276:immunology / Q000628:therapy*; D006801:Humans; D056724:Immunity, Humoral; D007074:Immunoglobulin G / Q000097:blood; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000276:immunology; D010951:Plasma Exchange
chemical_list: D007074:Immunoglobulin G