Improved Outcome up to Ten Years after Intravenous Immunoglobulin Therapy in Patients with Dilated Cardiomyopathy
Long-Term Benefits of Antibody Therapy for People with Dilated Cardiomyopathy
Dilated cardiomyopathy (DCM) is a condition in which the heart becomes enlarged and weakened, making it harder to pump blood effectively (so-called heart failure). In some patients, a common virus called parvovirus B19 remains in the heart and may contribute to ongoing inflammation and damage to the heart muscle. A previous study found that adding intravenous immunoglobulin (IVIg) (a treatment made from healthy donor antibodies) to standard heart failure treatment did not improve heart function after six months. In this study, we examined whether IVIg provided longer-term benefits and investigated how it affects the heart at the cellular level.
Fifty patients with DCM and a persistent parvovirus B19 infection in the heart were randomly assigned to receive either IVIg or a placebo (which means that the patient receives no treatment without knowing about it), alongside their usual treatment. Patients were followed for nearly seven years on average, and heart tissue samples were analyzed before treatment and six months after the treatment.
Patients who received IVIg were much less likely to experience serious heart-related events, such as death from heart disease, hospitalization for heart failure, or life-threatening abnormal heart rhythms, than those who received placebo. The heart tissue analyses showed that IVIg reduced the number of inflammatory immune cells in the heart, limited further damage to heart muscle cells, and decreased signals that promote inflammation and scar tissue formation. IVIg also appeared to improve the way heart muscle cells produce energy. These findings suggest that although IVIg did not improve heart function in the short term, it may help protect the heart over the long term by reducing harmful inflammation and preventing progressive heart damage in patients with DCM and persistent parvovirus B19 infection. However, as this was only a small study, these results need to be reproduced in additional patients.
Sikking MA, Peisker F, Maatz H, Lopez-Anguita N, Hazebroek MR, Henkens MTHM, Raafs AG, Heymans A, Stroeks S, Abdul Hamid MA, Li X, Vicenzetto C, Caforio ALP, Brunner-La Rocca HP, Knackstedt C, van Paassen P, van Empel VPM, Hubner N, Verdonschot JAJ, Heymans SRB. Improved Outcome up to Ten Years after Intravenous Immunoglobulin Therapy in Patients with Dilated Cardiomyopathy. Eur J Heart Fail. 2026 May 15:xuag134. doi: 10.1093/ejhf/xuag134. Epub ahead of print. PMID: 42135937.
Prepared byJob Verdonschot and Ruth Biller