PMU-Autor/inn/en
Pauschinger MatthiasAbstract
BACKGROUND
Viral infections are important causes of myocarditis and may induce cardiac dysfunction and finally lead to dilated cardiomyopathy. We investigated whether interferon (IFN)-beta therapy is safe and may achieve virus clearance and prevent deterioration of left ventricular (LV) function in patients with myocardial virus persistence.
In this phase II study, 22 consecutive patients with persistence of LV dysfunction (history of symptoms, 44+/-27 months) and polymerase chain reaction-proven enteroviral or adenoviral genomes were treated with 18x10(6) IU/week IFN-beta (Beneferon) subcutaneously for 24 weeks. Histological and immunohistological analysis of endomyocardial biopsies was used to characterize myocardial inflammation. LV diameters and ejection fraction were assessed by echocardiography and angiography, respectively. During the treatment period, IFN-beta was well tolerated by all patients. No patient deteriorated. Clearance of viral genomes was observed in 22 of 22 of patients after antiviral therapy. Virus clearance was paralleled by a significant decrease of LV end diastolic and end systolic diameters, decreasing from 59.7+/-11.1 to 56.5+/-10.0 mm (P<0.001) and 43.2+/-13.6 to 39.4+/-12.1 mm (P<0.001), respectively. LV ejection fraction increased from 44.6+/-15.5% to 53.1+/-16.8% (P<0.001).
A 6 months, IFN-beta treatment was safe in patients with myocardial enteroviral or adenoviral persistence and LV dysfunction and resulted in elimination of viral genomes (22 of 22 patients) and improved LV function (15 of 22 patients).
Useful keywords (using NLM MeSH Indexing)
Adenoviridae/drug effects
Adenoviridae/genetics
Adenoviridae/isolation*
purification
Antiviral Agents/therapeutic use
Biopsy
Cardiac Volume/drug effects
Cardiomyopathy, Dilated/complications
Cardiomyopathy, Dilated/drug therapy*
Cardiomyopathy, Dilated/virology
Cell Count
Disease Progression
Electrocardiography
Enterovirus/drug effects
Enterovirus/genetics
Enterovirus/isolation*
purification
Female
Heart/drug effects*
Heart/physiopathology
Heart/virology*
Hemodynamics/drug effects
Humans
Interferon-beta/adverse effects
Interferon-beta/therapeutic use*
Male
Middle Aged
Myocardium/pathology
Polymerase Chain Reaction
Stroke Volume/drug effects
T-Lymphocytes/pathology
Treatment Outcome
Ventricular Dysfunction, Left/complications
Ventricular Dysfunction, Left/drug therapy*
Ventricular Dysfunction, Left/virology
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