Abstract 2384: Autoantibodies against Cardiac Troponin I in Patients with Dilated Cardiomyopathy Predict Improvement of Cardiac Function by Immunoadsorption
Background: Cardiac troponins in blood are the most preferred markers of myocardial damage. It has been shown that the application of antibodies against cardiac Troponin I (cTnI-Ab) can induce dilation and dysfunction of the heart in mice. Furthermore we recently demonstrated that immunization with troponin I induces severe inflammation and fibrosis in the myocardium. In the present study patient sera from a clinical trial of immunoadsorption (IA) in DCM were retrospectively evaluated for the presence of cTnI antibodies before and after treatment; antibody titers were correlated with clinical outcome.
Methods and Results: 29 patients with DCM were included in this study. Every patient underwent heart catheterisation including myocardial biopsy and received IA. LVF was determined by trans-thoracic echocar-diography before and 6 month after IA was performed. An ELISA-Assay to measure cTnI-Ab-titers was established and serum from each patient was screened for the presence of cTnI-Ab. Out of 29 tested patients 18 had positive cTnI-Ab-titers and 11 were negative. Whereas LVF of patients with positive cTnI-Ab-titers improved after IA by +31,4% over the follow up period, patients with negative cTnI-Ab-titers only showed an improvement of +8,5% of LVF (p=0,04).
Conclusion: We demonstrate for the first time that the presence of cTnI-Abs in patients with DCM has an impact on the improvement of the LVF after IA over a study period of 6 months.