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DCM (dilated cardiomyopathy)

  

Dilated cardiomyopathy, a disease of the heart muscle, has a poor prognosis. It leads to a continuing increase in the size of both ventricles of the heart and increasing weakness in the pumping ability of the heart muscle. This results in a state in which the left ventricle is no longer able to pump out enough blood, limiting the functioning of the heart and leading ultimately to a critical reduction in the blood supply to all the organs. The resulting symptoms include rapid fatigue with extremely low capacity for physical activity. In the later stages, the heart is markedly enlarged and heart insufficiency is evident. When this heart muscle disease is accompanied by clinical signs of cardiac insufficiency, the likelihood of surviving the next 5 years is extremely low. The death rate in patients with DCM is still over 50% if they do not undergo heart transplantation. In this respect the prognosis for dilated cardiomyopathy is similar to that for other malignant diseases. New research results indicate that, in the majority of patients, DCM is caused by an inflammation of the heart muscle or a myocardial virus infection (myocarditis, inflammatory cardiomyopathy). If the initial problem does not heal completely, the inflammatory process develops into chronic inflammation of the heart muscle. This, in turn, results in the continual loss of heart muscle cells. In many cases the immune system acts not only against viruses but also - as a result of an error of immunological regulation - against proteins on the body's own heart muscle cells.

Internal Medicine Clinic B at Ernst Moritz Arndt University in Greifswald was the first centre to successfully use immune adsorption therapeutically to treat patients with DCM. The aim of the treatment was to separate out the antibodies targeting heart muscle cells and to remove them from the blood. Further investigations carried out by this group showed, for the first time, that the heart muscle inflammation also recovers as a result of immune adsorption treatment.

 

HIT (heparin induced thrombocytopenia)
Underlying Mechanisms