Table 2.
Trial | Study Design | Intervention | Patient # (Treated/Controls) | Baseline Characteristics | Follow-up | Results |
---|---|---|---|---|---|---|
Dorffel, 199759 | CS | IA for 5 days | 9/0 | NYHA III/IV, LVEF <25%, positive for B1AR autoantibodies | 5 days | Improved CO (3.7 ± 0.8 to 5.5 ± 1.8 L/min, P < .01), and decreased MAP (76.0 ± 9.9 to 65.0 ± 11.2 mm Hg, P < .05). |
Muller, 200023 | CC | IA for 5 days | 17/17 | NYHA II-IV, LVEF <30%, positive for B1AR autoantibodies | 12 months | Improved LVEF in treatment group (22.3 ± 3.3% to 37.9 ± 7.9%; P = .0001). No change in control group. Levels of B1AR autoantibodies decreased with IA and did not return during follow-up. |
Felix, 200060 | RCT | IA for 3 days with 0.5 g/kg of IgG substitution on day 3, followed by 2 sessions once per month for 3 months | 9/9 | NYHA III/IV, LVEF <30% | 3 months | Increased CI in the treatment group (2.3 ± 0.1 L/min/m2 to 3.0 ± 0.3 L/min/m2; P = .01 vs. baseline, P = .05 vs. controls). |
Wallukat, 200262 | CS | Selective removal of B1AR antibodies over 5 days | 8/0 | LVEF <35%, positive for B1AR autoantibodies | 12 months | Improved LVEF (28.5 ± 6.1 to 36.6. ± 10.7; P = .002). Levels of B1AR autoantibodies decreased with IA and did not return during follow-up. |
Felix,200261 | CC | IA for 3 days | 11/9 | NYHA III/IV, LVEF <30% vs. healthy controls | 3 days | Improved CI (2.2 ± 0.1 to 2.7 ± 0.2 L/min/m2; P < .01). |
Mobini, 200336 | CS | IA for 3 days with 0.5 g/kg of IgG substitution on day 3, followed by 2 sessions once per month for 3 months | 22/0 | NYHA III-IV, LVEF <30% | 3 months | No difference in CI and LVEF between B1AR antibody–positive and B1AR antibody–negative patients. |
Staudt, 200564 | CC | IA with improved IgG3 removal vs. normal IA | 9/9 | NYHA III/IV, LVEF <35% | 3 months | Greater improvement in LVEF using IA with improved IgG3 removal (24.3 ± 2 to 34.7 ± 4% vs. 21.6 ± 2% to 24.4 ± 2%; P < .05). |
Schimke, 200163 | CS | Selective removal of B1AR antibodies | 8/0 | Not reported | 12 months | Significant decrease in oxidative stress and an increase in wall motion velocity and LVEF. |
Staudt, 200666 | RCT | One session of IA vs. 1 session per month for 3 months | 11/11 | NYHA III/IV, LVEF <35% | 6 months | Improved LVEF (P < .01), but no difference between groups. |
Cooper, 2007 (65) | CS | IA for 5 days | 4/0 | NYHA II/III, mean LVEF 34.6 ± 12.3% | 6 months | Decrease in total IgG and IgG3 (P < .05), but no change in LVEF. |
B1AR, beta-1 adrenoreceptor; CC, case control; CI, cardiac index; CO, cardiac output; CS, case series; IA, immunoadsorption; LVEF, left ventricular ejection fraction; MAP, mean arterial pressure; NYHA, New York Heart Association class; RCT, randomized controlled trial; Ig, immunoglobulin.