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

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
    • Both authors contributed equally to this work.
    • Corresponding Author InformationReprint 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

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
    • Both authors contributed equally to this work.
  • ,
  • Michael Radermacher, MD

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
  • ,
  • Martin Vetter

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
  • ,
  • Juliane M. Wiehe, PhD

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
  • ,
  • Magdalena Bienek-Ziolkowski

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
  • ,
  • Vinzenz Hombach, MD

      Affiliations

    • Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany
  • ,
  • Jan Torzewski, MD

      Affiliations

    • Herz- und Gefäß-Zentrum Oberallgäu, Klinik Immenstadt, Immenstadt, Germany

Received 23 January 2009 ,Revised 22 October 2009 ,Accepted 17 December 2009.

References 

  1. Dec GW, Fuster V. Idiopathic dilated cardiomyopathy. N Engl J Med. 1994;331:1564–1575
  2. Coughlin SS, Neaton JD, Sengupta A, Kuller LH. Predictors of mortality from idiopathic dilated cardiomyopathy in 356,222 men screened for the Multiple Risk Factor Intervention Trial. Am J Epidemiol. 1994;139:166–172
  3. Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ. The current cost of heart failure to the National Health Service in the UK. Eur J Heart Failure. 2002;4:361–371
  4. Saß Hunt, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult. Circulation. 2005;112:1825–1852
  5. Cooper LT, Baughman KL, Feldman AM, Frustaci A, Jessup M, Kuhl U, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Circulation. 2007;116:2216–2233
  6. Kuhl U, Noutsias M, Seeberg B, Schultheiss HP. Immunohistological evidence for a chronic intramyocardial inflammatory process in dilated cardiomyopathy. Heart. 1996;75:295–300
  7. Dennert R, Crijns HJ, Heymans S. Acute viral myocarditis. Eur Heart J. 2008;29:2073–2082
  8. Hershberger RE, Lindenfeld J, Mestroni L, Seidman CE, Taylor MR, Towbin JA. Heart Failure Society of America. Genetic evaluation of cardiomyopathy—a Heart Failure Society of America practice guideline. J Card Fail. 2009;15:83–97
  9. Lappé JM, Pelfrey CM, Tang WH. Recent insights into the role of autoimmunity in idiopathic dilated cardiomyopathy. J Card Fail. 2008;14:521–530
  10. Mason JW, O'Connell JB, Herskowitz A, Rose NR, McManus BM, Billingham ME, et al. A clinical trial of immuno-suppressive therapy for myocarditis. The Myocarditis Treatment Trial Investigators. N Engl J Med. 1995;333:269–275
  11. Parrillo JE, Cunnion RE, Epstein SE, Parker MM, Suffredini AF, Brenner M, et al. A prospective, randomized, controlled trial of prednisone for dilated cardiomyopathy. N Engl J Med. 1989;321:1061–1068
  12. Wojnicz R, Nowalany-Kozielska E, Wojciechowska C, Glanowska G, Wilczewski P, Niklewski T, et al. Randomized, placebo-controlled study for immunosuppressive treatment of inflammatory dilated cardiomyopathy: two-year follow-up results. Circulation. 2001;104:39–45
  13. Aretz HT. Myocarditis: the Dallas criteria. Hum Pathol. 1987;18:619–624
  14. Pauschinger M, Bowles NE, Fuentes-Garcia FJ, Pham V, Kühl U, Schwimmbeck PL, et al. Detection of adenoviral genome in the myocardium of adult patients with idiopathic left ventricular dysfunction. Circulation. 1999;99:1348–1354
  15. Fujioka S, Kitaura Y, Ukimura A, Deguchi H, Kawamura K, Isomura T, et al. Evaluation of viral infection in the myocardium of patients with idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 2000;36:1920–1926
  16. Why HJ, Meany BT, Richardson PJ, Olsen EG, Bowles NE, Cunningham L, et al. Clinical and prognostic significance of detection of enteroviral RNA in the myocardium of patients with myocarditis or dilated cardiomyopathy. Circulation. 1994;89:2582–2589
  17. Kühl U, Pauschinger M, Seeberg B, Lassner D, Noutsias M, Poller W, et al. Viral persistence in the myocardium is associated with progressive cardiac dysfunction. Circulation. 2005;112:1965–1970
  18. Pankuweit S, Moll R, Baandrup U, Portig I, Hufnagel G, Maisch B. Prevalence of the parvovirus B19 genome in endomyocardial biopsy specimens. Hum Pathol. 2003;34:497–503
  19. Pankuweit S, Ruppert V, Eckhardt H, Strache D, Maisch B. Pathophysiology and aetiological diagnosis of inflammatory myocardial diseases with a special focus on parvovirus B19. J Vet Med B Infect Dis Vet Public Health. 2005;52:344–347
  20. Kühl U, Lassner D, Pauschinger M, Gross UM, Seeberg B, Noutsias M, et al. Prevalence of erythrovirus genotypes in the myocardium of patients with dilated cardiomyopathy. J Med Virol. 2008;80:1243–1251
  21. Tschöpe C, Bock CT, Kasner M, Noutsias M, Westermann D, Schwimmbeck PL, et al. High prevalence of cardiac parvovirus B19 infection in patients with isolated left ventricular diastolic dysfunction. Circulation. 2005;111:879–886
  22. Yilmaz A, Mahrholdt H, Athanasiadis A, Vogelsberg H, Meinhardt G, Voehringer M, et al. Coronary vasospasm as the underlying cause for chest pain in patients with PVB19 myocarditis. Heart. 2008;94:1456–1463
  23. Kühl U, Pauschinger M, Noutsias M, Seeberg B, Bock T, Lassner D, et al. High prevalence of viral genomes and multiple viral infections in the myocardium of adults with “idiopathic” left ventricular dysfunction. Circulation. 2005;111:887–893
  24. Heim A, Stille-Siegener M, Kandolf R, Kreuzer H, Figulla HR. Enterovirus-induced myocarditis: hemodynamic deterioration with immunosuppressive therapy and successful application of interferon-alpha. Clin Cardiol. 1994;17:563–565
  25. Maisch B, Hufnagel G, Kölsch S, Funck R, Richter A, Rupp H, et al. Treatment of inflammatory dilated cardiomyopathy and (peri)myocarditis with immunosuppression and i.v. immunoglobulins. Herz. 2004;29:624–636
  26. Lutton CW, Gauntt CJ. Ameliorating effect of IFN-beta and anti-IFN-beta on coxsackievirus B3-induced myocarditis in mice. J Interferon Res. 1985;5:137–146
  27. Kühl U, Pauschinger M, Schwimmbeck PL, Seeberg B, Lober C, Noutsias M, et al. Interferon-β treatment eliminates cardiotropic viruses and improves left ventricular function in patients with myocardial persistence of viral genomes and left ventricular dysfunction. Circulation. 2003;107:2793–2798
  28. Schultheiss HP, Piper C, Sowade O, Karason K, Kapp JF, Wegscheider K, et al. The Effect of subcutaneous treatment with interferon-Beta-1b over 24 weeks on safety, virus elimination and clinical outcome in patients with chronic viral cardiomyopathy. [abstract] Circulation. 2008;118:2312
  29. Zimmermann O, Kochs M, Zwaka TP, Kaya Z, Lepper PM, Bienek-Ziolkowski M, et al. Myocardial biopsy based classification and treatment in patients with dilated cardiomyopathy. Int J Cardiol. 2005;104:92–100
  30. Kawai C. From myocarditis to cardiomyopathy: mechanisms of inflammation and cell death. Circulation. 1999;99:1091–1100
  31. Gutberlet M, Spors B, Thoma T, Bertram H, Denecke T, Felix R, et al. Suspected chronic myocarditis at cardiac MR: diagnostic accuracy and association with immunohistologically detected inflammation and viral persistence. Radiology. 2008;246:401–409
  32. Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T, et al. Predictors of outcome in patients with suspected myocarditis. Circulation. 2008;118:639–648
  33. Schenk T, Enders M, Pollak S, Hahn R, Huzly D. High prevalence of human parvovirus B19 DNA in myocardial autopsy samples from subjects without myocarditis or dilated cardiomyopathy. J Clin Microbiol. 2008;12:[Epub ahead of print]
  34. Kuethe F, Sigusch HH, Hilbig K, Tresselt C, Glück B, Egerer R, et al. Detection of viral genome in the myocardium: lack of prognostic and functional relevance in patients with acute dilated cardiomyopathy. Am Heart J. 2007;153:850–858
  35. Schultheiss HP, Kühl U. Entzündliche Herzerkrankungen. In:  Classen D,  Kochsiek L,  Böhm M,  Schmiegel I editor. Lehrbuch Innere Medizin. 6th ed. München, Germany: Urban & Fischer; 2007;
  36. Staudt A, Felix SB. Immunomodulatory and immunoadsorptive treatments. Heart Fail Clin. 2005;1:457–465
  37. Vallbracht KB, Schwimmbeck PL, Kühl U, Seeberg B, Schultheiss HP. Endothelium-dependent flow-mediated vasodilation of systemic arteries is impaired in patients with myocardial virus persistence. Circulation. 2004;110:2938–2945
  38. Bültmann BD, Klingel K, Sotlar K, Bock CT, Baba HA, Sauter M, et al. Fatal parvovirus B19-associated myocarditis clinically mimicking ischemic heart disease: an endothelial cell-mediated disease. Hum Pathol. 2003;34:92–95
  39. Mahrholdt H, Wagner A, Deluigi CC, Kispert E, Hager S, Meinhardt G, et al. Presentation, patterns of myocardial damage, and clinical course of viral myocarditis. Circulation. 2006;114:1581–1590

 Supported in part by the Deutsche Stiftung für Herzforschung.

PII: S1071-9164(09)01236-6

doi: 10.1016/j.cardfail.2009.12.016

Journal of Cardiac Failure
Volume 16, Issue 4 , Pages 348-356 , April 2010