Decreased oxidative stress in patients with idiopathic dilated cardiomyopathy one year after immunoglobulin adsorption

Objectives In a substudy to a recently reported investigation that demonstr ated the benefit of immunoglobulin adsorption (immunoadsorption) for patien ts with idiopathic dilated cardiomyopathy (IDC), we tested whether this ben efit is associated with a reduction of oxidative stress. Background The progression of cardiomyopathy is believed to be related to t he increase of oxidative stress. Therefore, reduction of oxidative stress c ould be one of the effects of immunoadsorption for improvement of cardiac p erformance and clinical status. Methods Plasma markers for oxidative stress-thiobarbituric acid-reactive su bstances (TBARS), lipid peroxides (LPO), anti-oxidized low-density lipoprot ein-autoantibodies (anti-oxLDL-AB), thiol groups and vitamin E-were compare d in 31 patients, of whom 16 underwent immunoadsorption and 15 received con ventional treatment (controls). All patients received a daily supplement of vitamins, minerals and trace elements. Results After one year, TEARS (p = 0.026), LPO (p = 0.026) and anti-oxLDL-A B (p = 0.044) were decreased in the immunoadsorption group bile not in the controls. Thiols were unchanged in the immunoadsorption group but were decr eased in the controls (p = 0.001). Vitamin E accumulated in both groups (im munoadsorption: p = 0.001; controls: p = 0.031) with a trend for stronger a ccumulation after immunoadsorption (p = 0.09). Prior to the study, the anti -oxLDL-AB to left ventricular ejection fraction (LVEF) (p = 0.05) were inve rsely correlated. After one year, correlations with borderline significance were calculated for TEARS to New York Heart Association functional class ( p = 0.081) and inversely for LPO to LVEF (p = 0.083). Conclusions Effective therapy in patients with IDC, such as immunoadsorptio n which improved cardiac performance and clinical status, is associated wit h a reduction of oxidative stress. (J Am Coll Cardiol 2001;38:178-83) (C) 2 001 by the American College of Cardiology.