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Effect of gamma globulin combined with creatine phosphate on viral myocarditis
Jing-Hui Li1, Ting-Ting Li2, Xing-Sen Wu1
1Zhangzhou Zhengxing Hospital Zhangzhou, China.
Insights
Intravenous immunoglobulin (IVIG) and creatine phosphate (CP) combination therapy significantly improved outcomes for patients with viral myocarditis (VMC). This treatment enhanced cardiac function and immune markers without increasing adverse events.
Area of Science:
- Cardiology
- Immunology
- Virology
Background:
- Viral myocarditis (VMC) is a serious cardiac condition.
- Effective treatment strategies for VMC are crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the therapeutic effects of combining intravenous immunoglobulin (IVIG) with creatine phosphate (CP) in patients diagnosed with VMC.
- To assess the impact of this combination therapy on cardiac function, myocardial injury markers, and immune status.
Main Methods:
- A cohort of 121 young patients with VMC were divided into a study group (IVIG + CP + routine treatment) and a control group (conventional treatment).
- Cardiac function parameters (ejection fraction, fractional shortening, E/A ratio), myocardial enzyme levels (LDH, CK, AST, CK-MB, CTnI), and immune factors (CD3+, CD4+, CD8+) were measured before and after treatment.
- Clinical response rates, symptom recovery, and adverse events were compared between the groups.
Main Results:
- The study group demonstrated a significantly higher overall response rate compared to the control group.
- Significant improvements in ejection fraction, fractional shortening, E/A ratio, ECG findings, and myocardial enzyme levels were observed in the study group.
- Faster recovery of symptoms, cardiac function, and normalization of myocardial enzymes were noted in the IVIG + CP group, with comparable adverse reaction rates to the control group.
Conclusions:
- The combination of IVIG and CP offers superior clinical efficacy in treating VMC compared to conventional therapy alone.
- This combined treatment effectively enhances cardiac function and modulates immune responses in VMC patients.
- IVIG and CP combination therapy presents a promising therapeutic option for viral myocarditis with a favorable safety profile.
Objective:
This study aimed to investigate the effect of gamma globulin (IVIG) and creatine phosphate (CP) on viral myocarditis (VMC).
Methods:
We enrolled 121 young patients with VMC who were admitted in our hospital from February 2017 to September 2018, and divided them into two groups as follows: study group (62 patients, IVIG + CP + routine treatment), and control group (59 patients, conventional treatment). Patient's baseline data, including gender, age, disease course, etiology, cardiac function classification, and severity, were collected. Ejection fraction (EF), fractional shortening (FS), and mitral ratio of peak early to late diastolic filling velocity (E/A ratio) before and after treatment were recorded. These changes include the lactate dehydrogenase, creatine kinase (CK), aspartate aminotransferase, creatine kinase isoenzyme (CK-MB), and cardiac troponin I (CTnI). Furthermore, the changes in immune factors such as CD3+, CD4+, and CD8+ before and after the treatment were determined.
Results:
The study group had a significantly higher response rate than the control group (P < 0.05). After treatment, the ejection fraction, fractional shortening, and mitral ratio of peak early-to-late diastolic filling velocity were more significantly improved in the study group than in the control group (P < 0.05). The electrocardiogram (ECG) results of the study group were also significantly better than those of the control group (P < 0.05). The levels of lactate dehydrogenase (LDH), creatine kinase (CK), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), and cardiac troponin I (CTnI) in the study group were all significantly better than those in the control group (P < 0.05). Symptom recuperation, cardiac function recovery, and ECG and myocardial enzyme normalization were significantly faster in the study group than those in the control group (P < 0.05). The immune factor levels in the study group also significantly improved compared with those before the treatment (P < 0.05). Meanwhile, the adverse reactions in both groups showed no differences (P < 0.05).
Conclusion:
IVIG combined with CP exhibited better clinical effects and effectively boosted the immune system of patients with VMC.
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