Effects of Immunoadsorption on the nt‐BNP and nt‐ANP Plasma Levels of Patients Suffering From Dilated Cardiomyopathy^†

Abstract

Immunoadsorption (IA) represents an additional therapeutic approach in patients with severe heart failure due to dilated cardiomyopathy (DCM). nt-BNP and nt-ANP plasma levels are prognostic markers in patients with heart failure. The effect of IA on nt-BNP and nt-ANP plasma levels is unknown. In this case control study, 30 patients suffering from severe heart failure (LVEF < 35%) due to DCM were included. In 15 patients, IA was carried out in four courses of monthly intervals until month 3. For analysis of the acute and prolonged effects, the plasma levels of nt-BNP and nt-ANP were determined before and after each IA course. In 15 comparable DCM patients (controls), plasma levels of nt-BNP and nt-ANP were determined at baseline and after 3 months. LVEF remained stable during this study in the control group. In contrast, in the IA group after 3 months, LVEF increased from 29.7 +/- 1 to 38.6 +/- 2%, P < 0.001. In the control group, the nt-BNP and nt-ANP plasma levels remained stable during the 3 months of the study. In the IA group after the first IA course, the level of nt-BNP was acutely reduced from 1501 +/- 328 to 925 +/- 151 fmol/mL, P < 0.01. In addition, the nt-ANP level was reduced from 4439 +/- 1271 to 2897 +/- 825 fmol/mL, P < 0.01. In the IA group, the reduction of these two parameters remained detectable after 3 months before the last course: nt-BNP: 714 +/- 119 fmol/mL, nt-ANP: 2227 +/- 427 fmol/mL, P < 0.05. The improvement of left ventricular function during IA is accompanied by a reduction of nt-BNP and nt-ANP plasma levels in patients with DCM.

Variants of Toll-like Receptor 4 Predict Cardiac Recovery in Patients with Dilated Cardiomyopathy

“…However, there was no statistically significant difference among the patients groups. Finally, the minor allele frequencies of both TLR4 variants are rather low as reported previously (16,23,24). Consequently, the frequency of the rs4986790 and rs47986791 haplotype is even lower.…”

“…Quantification of NT-pro-BNP and C-reactive Protein-We measured NT-probrain natriuretic peptide (NT-pro-BNP) plasma levels at first admission and during the follow up using an enzyme-linked immunosorbent assay (ELISA; Biomedica, Vienna, Austria) as described previously (24). C-reactive protein (CRP) was determined at the same time points using an immunoassay (Siemens, Germany).…”

Nierenersatztherapie bei schwerer Herzinsuffizienz

“…Auch neurohumorale Marker der Herzinsuffizienz wie nt-BNP wurden durch die Immunadsorption positiv beeinflusst [46]. Neben der Verbesserung der kontraktilen Funktion reduziert die Immunadsorption auch die Lymphozyteninfiltration im Myokard [44].…”

Immunadsorption als Therapieverfahren der dilatativen Kardiomyopathie

“…Die neurohumoralen Mediatoren nt-BNP und nt-ANP stellen wichtige prognostische Marker der Herzinsuffizienz dar. In einer Case-control-Studie konnte gezeigt werden, dass die IA diese prognostischen Parameter positiv beeinflusst [29]. Es ist jedoch noch nicht geklärt, welchen Einfluss eine IA auf die langfristige Prognose von DCM-Patienten hat.…”