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June 3, 1997Circulation

Intravenous Immune Globulin in the Therapy of Myocarditis and Acute Cardiomyopathy

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Why the study?

Does high-dose intravenous immune globulin improve LVEF and functional status in adults with new-onset dilated cardiomyopathy and severe heart failure?

Population

10 adult patients hospitalized with new-onset dilated cardiomyopathy/myocarditis, NYHA class III to IV heart…

Design

Case_series

Follow-up

12 months

Authors

DMDennis M. McNamaraHeart Failure / CardiomyopathyWRWarren D. RosenblumAlbert Einstein College of MedicineKJKaren JanoskoCleveland Clinic

Discussion

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Implication

May suggest IVIG benefit in new-onset DCM; hypothesis-generating and requires RCTs before any practice change.

Structured PICO

Does high-dose intravenous immune globulin improve LVEF and functional status in adults with new-onset dilated cardiomyopathy and severe heart failure?

P
Population
10 adult patients hospitalized with new-onset dilated cardiomyopathy/myocarditis, NYHA class III to IV heart failure, left ventricular ejection fraction (LVEF) < 0.40, and symptoms for < 6 months.
I
Intervention
High-dose intravenous immune globulin (IVIG) infusions (2 g/kg).
O
Outcome
Change in left ventricular ejection fraction (LVEF) at 12 months after therapy.surrogate

High-dose intravenous immune globulin significantly improved LVEF and NYHA functional class in a small series of adults with new-onset dilated cardiomyopathy, suggesting a potential benefit that warrants randomized trials.

Limitations

  • Small sample size
  • Lack of a randomized control group

Cite This Study

McNamara et al. (1997) studied this question.

synapsesocial.com/papers/6a092f054c1e2db30bd261cfhttps://doi.org/10.1161/01.cir.95.11.2476

Topics

Myocarditis
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Active Myocarditis in the Spectrum of Acute Dilated Cardiomyopathies1985 · 569 citations
  2. 2Polyclonal immunoglobulin therapy protects against cardiac damage in experimental coxsackievirus-induced myocarditis1992 · 45 citations
  3. 3Detection of enterovirus RNA in myocardial biopsies from patients with myocarditis and cardiomyopathy using gene amplification by polymerase chain reaction.1990 · 311 citations
  4. 4Circulating Heart Autoantibodies in Familial as Compared With Nonfamilial Idiopathic Dilated Cardiomyopathy1994 · 35 citations
  5. 5Heart Failure: Management of Patients With Left‐Ventricular Systolic Dysfunction1996 · 35 citations