Heart failure & cardiomyopathiesSecondary analysis
Improved outcome up to 10 years after intravenous immunoglobulin therapy in patients with dilated cardiomyopathy
- Long-term follow-up of a randomised controlled trial with mechanistic analysis
- blinded
- placebo-controlled
Authors' conclusion
In patients with DCM and cardiac B19V persistence, IVIg added to GDMT correlated with improved long-term clinical outcome.
Study context
- Population
- Patients with dilated cardiomyopathy (DCM) and cardiac parvovirus-B19 (B19V) persistence
- Participants
- 50 patients
- Comparison
- IVIg added to guideline-directed medical therapy (GDMT) vs placebo
- IVIgn = 26
- Placebon = 24reference
- Primary endpoint
- Composite of:
- Cardiac death
- HF hospitalization
- Life-threatening arrhythmia
- Follow-up
- Median 6.8 [5.6-10.3] years
Primary result
As reported in the abstract
Composite endpoint:
- Cardiac death
- HF hospitalization
- Life-threatening arrhythmia
IVIg
1/26
1 of 26
Placebo
8/24
8 of 24
P = 0.0075
Further findings
Endomyocardial biopsy single-nuclear RNA sequencing (snRNA-seq), baseline vs 6 months
- IVIg reduced cardiac monocyte infiltration and, unlike placebo, prevented expansion of injured cardiomyocytes
- IVIg induced transcriptomic reprogramming: diminished myeloid-to-fibroblast signaling with reduced TGFβ activity, decreased pro-fibrotic and pro-inflammatory pathways, enhanced oxidative phosphorylation in cardiomyocytes
Original publication
Improved outcome up to 10 years after intravenous immunoglobulin therapy in patients with dilated cardiomyopathy. Eur J Heart Fail. Published 15 May 2026. doi:10.1093/ejhf/xuag134
Summarised from the published abstract; every number is checked against it