免疫吸附治疗难治性心力衰竭合并扩张型心肌病:一种潜在的治疗选择。

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Yuksel Cavusoglu, Senan Tahmazov, Selda Murat, Olga Meltem Akay
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引用次数: 0

摘要

目的:免疫吸附法去除心脏自身抗体可能改善扩张型心肌病的临床疗效。在这项初步研究中,我们研究了免疫吸附治疗难治性心力衰竭合并扩张型心肌病患者的疗效和安全性。方法:9例心衰合并扩张型心肌病患者,NYHA III-IV,左心室射血分数。平均左室射血分数和6分钟步行距离在3个月时显著增加(左室射血分数从23.27±5.09增加到32.1±1.7%,p=0.01, 6分钟步行距离从353±118增加到434±159 m, p=0.04),并在免疫吸附治疗后6个月进一步增加(射血分数为34.5±7.7%,p=0.02, 6分钟步行距离为441±136 m, p=0.04)。6个月时NT-proBNP水平从1161(392.8-3034)降至385(116.1-656.5)ng/L (p=0.04),高敏c反应蛋白从9.74±0.96降至4.3±5.8 mg/L (p=0.04)。左室舒张末期内径(66.1±5.8比64.7±8.9 mm)和左室收缩末期内径(56.1±8.6比52.3±10.8 mm)有减小的趋势,但无统计学意义。免疫吸附手术后肌酐、心肌肌钙蛋白- 1和血红蛋白水平未见明显恶化。结论:在扩张型心肌病合并难治性心衰患者中,免疫吸附可能被认为是一种潜在有用的治疗选择,可以改善患者的临床状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Immunoadsorption therapy in refractory heart failure patients with dilated cardiomyopathy: a potential therapeutic option.

Immunoadsorption therapy in refractory heart failure patients with dilated cardiomyopathy: a potential therapeutic option.
SUMMARY OBJECTIVE: Removal of cardiac autoantibodies by immunoadsorption might confer clinical improvement in dilated cardiomyopathy. In this pilot study, we investigated the efficacy and safety of immunoadsorption therapy in refractory heart failure patients with dilated cardiomyopathy. METHODS: This study consisted of 9 heart failure patients with dilated cardiomyopathy, NYHA III-IV, left ventricular ejection fraction <30%, unresponsive to heart failure therapy, and with cardiac autoantibodies. Patients underwent immunoadsorption therapy for five consecutive days using a tryptophan column. Changes in cardiac function (left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter), exercise capacity (6-minute walk distance), neurohormonal (N-terminal pro-brain natriuretic peptide), proinflammatory (high-sensitive C-reactive protein), and myocardial (cardiac troponin-I), biochemical, and hematological variables were obtained at baseline and after 3 and 6 months of immunoadsorption therapy. RESULTS: Mean left ventricular ejection fraction and 6-minute walk distance significantly increased at 3 months (from 23.27±5.09 to 32.1±1.7%, p=0.01 for left ventricular ejection fraction and from 353±118 to 434±159 m, p=0.04 for 6-minute walk distance) and further increased at 6 months after immunoadsorption therapy (to 34.5±7.7%, p=0.02 for ejection fraction and to 441±136 m, p=0.04 for 6-minute walk distance). NT-proBNP level reduced from 1161(392.8–3034) to 385(116.1–656.5) ng/L (p=0.04), and high-sensitive C-reactive protein decreased from 9.74±0.96 to 4.3±5.8 mg/L (p=0.04) at 6 months. Left ventricular end-diastolic diameter (66.1±5.8 vs. 64.7±8.9 mm) and left ventricular end-systolic diameter (56.1±8.6 vs. 52.3±10.8 mm) tended to decrease but did not reach statistical significance. No significant worsening was observed in creatinine, cardiac troponin-I, and hemoglobin levels after the immunoadsorption procedure. CONCLUSION: In dilated cardiomyopathy patients with refractory heart failure, immunoadsorption may be considered a potentially useful therapeutic option to improve a patient's clinical status.
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来源期刊
CiteScore
2.20
自引率
0.00%
发文量
276
审稿时长
12 weeks
期刊介绍: A Revista da Associação Médica Brasileira (RAMB), editada pela Associação Médica Brasileira, desde 1954, tem por objetivo publicar artigos que contribuam para o conhecimento médico.
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