PITTSBURGH, June 5, 1997 — Cardiac researchers at the University of Pittsburgh Medical Center (UPMC) have found that patients with acute cardiomyopathy who were treated with high doses of intravenous immune globulin, human antibodies, showed a significant improvement in heart function to the extent that they were removed from the heart transplant waiting list.
The study, led by Dennis McNamara, M.D., assistant professor of medicine and director of the cardiomyopathy clinic at the UPMC, appears in the current issue of the American Heart Association journal Circulation.
"Immune globulin is frequently used to treat other autoimmune diseases but has never been looked at in adults with inflammatory heart disease," Dr. McNamara said. "We wanted to determine if patients with recent onset acute primary dilated cardiomyopathy, who were sick enough to need a heart transplant, might improve with therapy sufficiently to delay or prevent the need for heart transplantation."
Heart failure due to dilated cardiomyopathy affects more than 100,000 people in the United States and is a major reason for heart transplant in young adults. Studies have suggested that it may result from a common viral infection, causing in some patients an autoimmune response in which the body attacks itself.
The study followed 10 patients, one of whom died before the therapy could be completed. The remaining nine patients were given the intravenous immune globulin for up to four days and discharged from the hospital. Patients ranged in age from 18 to 60 years and all were awaiting a heart transplant.
After one year, all nine of the patients were alive and showed an improved left ventricular ejection fraction, the percentage of blood ejected from the heart during each beat.
"The immune globulin essentially reset the body's immune system and allowed the body to heal itself," he said. "The average increase in ejection fractions was twice what had been reported using other treatments. All had a marked improvement in their exercise capacity and quality of life. All were working and none of them, two years after treatment, have been readmitted to the hospital with heart failure.
"No patient required a heart transplant and, in fact, they have all been removed from the waiting list because they are doing so well."
In contrast, during the same study period, 72 additional patients were treated conventionally. In this group, 31 percent either died or received transplants after one year.
"We are now in the middle of a multi-center trial which will include 60 patients nationwide," said Dr. McNamara. "We are excited by the results of this initial study, but we need a controlled trial in a large group before we know what role immune globulin will play in the treatment of this illness."
Please visit the University of Pittsburgh Medical Center's Cardiovascular Institute website for more information on cardiology services and programs.