Interferon β-1b Therapy in Chronic Viral Dilated Cardiomyopathy—Is There a Role for Specific Therapy?

Zimmermann, Oliver; Rodewald, Christoph; Radermacher, Michael; Vetter, Martin; Wiehe, Juliane M.; Bienek-Ziolkowski, Magdalena; Hombach, Vinzenz; Torzewski, Jan

doi:10.1016/j.cardfail.2009.12.016

« Previous Next »Journal of Cardiac Failure
Volume 16, Issue 4 , Pages 348-356, April 2010

Interferon β-1b Therapy in Chronic Viral Dilated Cardiomyopathy—Is There a Role for Specific Therapy?

Oliver Zimmermann, MD
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
- Both authors contributed equally to this work.
- Reprint requests: Dr. Oliver Zimmermann, University of Ulm, Department of Internal Medicine II-Cardiology, Albert-Einstein-Allee 23, 89081 Ulm, Germany. Tel.: +49 731 500- 45090; Fax: +49 731 500- 45005.
Christoph Rodewald, MD
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
- Both authors contributed equally to this work.
Michael Radermacher, MD
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
Martin Vetter
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
Juliane M. Wiehe, PhD
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
Magdalena Bienek-Ziolkowski
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
Vinzenz Hombach, MD
- Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
Jan Torzewski, MD
- Herz- und Gefäß-Zentrum Oberallgäu, Klinik Immenstadt, Immenstadt, Germany

Received 23 January 2009; received in revised form 22 October 2009; accepted 17 December 2009. published online 08 February 2010.

Abstract

Background

Myocardial biopsy can be used for the detection of viral genome in dilated cardiomyopathy (DCM). Pilot studies have previously reported beneficial effects on clinical outcome and safety of an antiviral therapy using interferon β-1b in chronic viral DCM.

Methods and Results

Myocardial biopsies were taken from patients with DCM. Using polymerase chain reaction and Southern Blot analysis, viral genome could be detected in 49% of patients. In 42 patients with viral infection, off-label use with interferon β-1b was initiated. A further 68 patients formed the control group. The outcome was evaluated after follow-up with echocardiography, exercise electrocardiogram, and New York Heart Association class. A total of 81 men and 29 women with a median left ventricular ejection fraction of 34% were included. The follow-up period was 36 months. In 33 (79%) patients with interferon β-1b treatment, minor adverse reactions occurred, but no major adverse events were reported. No significant benefit for interferon β-1b treatment on clinical outcome could be detected during follow-up.

Conclusions

Off-label use with interferon β-1b in patients with viral DCM is feasible and safe under routine clinical practice. Concerning the herein evaluated clinical outcome parameters, promising results from pilot studies could not be confirmed. High prevalence of parvovirus B19 (92%) might influence the results.

Key Words: Virus, biopsy, heart failure, outcome, interferon β-1b