Recent-onset dilated cardiomyopathy associated with Borrelia burgdorferi infection
Language English Country Germany Media print-electronic
Document type Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
PubMed
25939436
DOI
10.1007/s00059-015-4308-1
PII: 10.1007/s00059-015-4308-1
Knihovny.cz E-resources
- Keywords
- Antibiotics, Borrelia burgdorferi, Dilated cardiomyopathy, Endomyocardial biopsy, Lyme disease,
- MeSH
- Anti-Bacterial Agents administration & dosage MeSH
- Endocarditis, Bacterial diagnosis drug therapy microbiology MeSH
- Borrelia burgdorferi isolation & purification MeSH
- Ceftriaxone administration & dosage MeSH
- Cardiomyopathy, Dilated diagnosis drug therapy microbiology MeSH
- Injections, Intravenous MeSH
- Cardiotonic Agents administration & dosage MeSH
- Drug Therapy, Combination methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Lyme Disease diagnosis drug therapy microbiology MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Controlled Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
- Ceftriaxone MeSH
- Cardiotonic Agents MeSH
BACKGROUND: Several recent small studies have suggested a causal link between Lyme disease and dilated cardiomyopathy (DCM) by demonstrating the presence of the Borrelia burgdorferi (Bb) genome in the myocardium of patients with recent-onset DCM. The aim of this study was to further investigate the effect of targeted antibiotic treatment of Bb-related recent-onset DCM in a larger cohort of patients. PATIENTS AND METHODS: We performed endomyocardial biopsy (EMB) in 110 individuals (53 ± 11 years, 34 women) with recent-onset unexplained DCM, and detected the Bb genome in 22 (20 %) subjects. Bb-positive patients were subsequently treated with intravenous ceftriaxone for 21 days in addition to conventional heart failure medication. RESULTS: At the 1-year follow-up, a significant improvement in left ventricular (LV) ejection fraction (26 ± 6 vs. 44 ± 12 %; p < 0.01) and a decrease in LV end-diastolic (69 ± 7 vs. 63 ± 11 mm; p < 0.01) and end-systolic (61 ± 9 vs. 52 ± 4 mm; p < 0.01) diameters were documented. Moreover, a significant improvement in heart failure symptoms (NYHA class 3.4 ± 0.6 vs. 1.5 ± 0.7; p < 0.01) was also observed. CONCLUSION: Targeted antibiotic treatment of Bb-related recent-onset DCM in addition to conventional heart failure therapy is associated with favorable cardiac remodeling and improvement of heart failure symptoms.
International Clinical Research Center St Anne's University Hospital in Brno Brno Czech Republic
The National Institute of Public Health Prague Czech Republic
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