Immunosuppressive treatment and immunoadsorption are beneficial for autoimmune inflammatory cardiomyopathy but not for cases with viral persistence.
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May support immunosuppression in autoimmune but not viral inflammatory cardiomyopathy; hypothesis-generating pending randomized trials.
Chronic autoimmunity and viral persistence constitute prognostic factors for adverse outcome in dilated cardiomyopathy patients. Inflammatory cardiomyopathy is a specific cardiomyopathy entity diagnosed in approximately 50% of dilated cardiopmyopathy patients by immunohistological quantification of immunocompetent infiltrates and cell adhesion molecule abundance. Patients with autoimmune inflammatory cardiomyopathy benefit from immunosuppressive treatment and immunoadsorption by improvement of left ventricular ejection fraction and heart failure symptoms, paralleled by a significant suppression of intramyocardial inflammation. However, dilated cardiomyopathy patients with viral persistence do not respond favorably to immunosuppression.
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Noutsias et al. (2004) studied this question.
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