Acute hemodynamic effects during immunoadsorption in patients with dilated cardiomyopathy positive for beta 1-adrenoceptor autoantibodies.

In two recent studies immunoadsorption improved left ventricular function in patients with dilated cardiomyopathy (DCM) who were positive for cardiostimulatory autoantibodies against the human beta 1-adrenoceptor (beta 1-AAB). In this study we invasively measured acute hemodynamics during immunoadsorption. Three patients with DCM, who were positive for beta 1-AAB (NYHA-class III, left ventricular ejection fraction < 0.3), were treated with 1 immunoadsorption session daily on 5 consecutive days. Immunoadsorption induced a strong decrease of cardiac index, whereas systemic vascular resistance increased. Baseline levels were reached again several hours after therapy ended. We conclude that during immunoadsorption substantial hemodynamic changes occur in patients positive for beta 1-AAB.