Effects of immunoadsorption on endothelial function, circulating endothelial progenitor cells and circulating microparticles in XXXX with inflammatory dilated cardiomyopathy.

@entity1 @entity712 @entity296 @entity4404 @entity2279 @entity450 @entity319 @entity2280 @entity27463 @entity1370
BACKGROUND: Immunoadsorption (IA) is used in @entity1 with chronic @entity296 ( @entity296 ) to remove @entity1370 autoantibodies, and to improve myocardial function. We examined the effects of IA on endothelial function, circulating endothelial progenitor cells, and circulating microparticles, including endothelial-derived microparticles, in @entity1 with chronic @entity296 . METHODS: Thirteen @entity1 (10 males, 3 females, mean age 52.3  years) with advanced @entity712 (NYHA III and IV) secondary due to chronic @entity296 (with signs of @entity296 in biopsies, but without persistence of virus genome), and reduced left ventricular ejection fraction (EF  <  35%) underwent IA. Blood samples were drawn before an IA course of 5  days, and 6  months after IA. Blood levels of endothelial progenitor cells (EPCs as defined as @entity319 (+) @entity2280 (+) cells), of microparticles (MPs as defined as @entity4404 (+) particles with a diameter between 0.1 and 1   m), and of endothelial-derived MPs (eMPs as defined as @entity2279 (+bright) @entity27463 (-)/ @entity4404 (+) particles) were analyzed by flow cytometry. Endothelial function (expressed as reactive @entity450 index (RHI)) and arterial stiffness were assessed by PAT-technology (peripheral arterial tone) using fingertips. RESULTS: Left ventricular systolic function (EF%) improved on average at 6  months from 26.3      4.8 to 37.9      9.6% (mean      SEM; p  <  0.05). The LV end-diastolic diameter reduced after 6  months from 68.4      8.2 to 61.6      7.9  mm; p  <  0.05). Endothelial function improved from 1.53      0.09 to 1.80      0.12 (p  <  0.05). The arterial stiffness index remained unchanged. Number of total MPs decreased on average by 36.8% (p  <  0.05), the number of eMPs by 39.6% (p  <  0.05), respectively. The level of circulating EPC remained unchanged (EPC/PMNC 0.26      0.07 vs. 0.27      0.05    , p  =  n.s.). CONCLUSIONS: IA treatment improves endothelial function in @entity1 with chronic @entity296 . This effect is associated with a significant drop in circulating microparticles. The causal relationship between circulating microparticles and endothelial function is discussed.
