{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:03:22Z","timestamp":1781625802623,"version":"3.54.5"},"reference-count":28,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chan Zuckerberg Foundation"},{"DOI":"10.13039\/501100001674","name":"Leducq Foundation","doi-asserted-by":"publisher","award":["16CVD03"],"award-info":[{"award-number":["16CVD03"]}],"id":[{"id":"10.13039\/501100001674","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010447","name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung","doi-asserted-by":"publisher","award":["SP\/19\/1\/34461"],"award-info":[{"award-number":["SP\/19\/1\/34461"]}],"id":[{"id":"10.13039\/100010447","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010447","name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung","doi-asserted-by":"publisher","award":["DFG SFB-1470"],"award-info":[{"award-number":["DFG SFB-1470"]}],"id":[{"id":"10.13039\/100010447","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007601","name":"European Union Horizon 2020 Research and Innovation Program","doi-asserted-by":"publisher","award":["AdG788970"],"award-info":[{"award-number":["AdG788970"]}],"id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Dutch Heart Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"crossref"}]},{"name":"ERA4HEALTH CardInnov"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>A previous trial of intravenous immunoglobulin therapy (IVIg) added to guideline-directed medical therapy (GDMT) in patients with dilated cardiomyopathy (DCM) and cardiac parvovirus-B19 (B19\u2005V) persistence showed no improvement of cardiac function at 6 months follow-up. We investigated whether IVIg confers long-term clinical benefits and analysed its molecular and cellular effects in cardiac tissue to elucidate the immunomodulatory mechanisms underlying the observed long-term clinical improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty patients with DCM and cardiac B19\u2005V were blindly randomized to receive either IVIg (n = 26; 2\u2005g\/kg\/day over 4 days) or placebo (n = 24). The composite clinical endpoint\u2014cardiac death, heart failure hospitalization, and life-threatening arrhythmia\u2014was assessed after a median follow-up of 6.8 (5.6\u201310.3) years. To investigate IVIg-associated molecular changes in the heart, single-nuclear RNA sequencing (snRNA-seq) sequencing on endomyocardial biopsies (EMB) obtained at baseline (prior to treatment) and at 6 months after randomization was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The IVIg group experienced fewer composite endpoint events (n = 1\/26) than the placebo group (8\/24; P = .0075). Comparison of baseline and 6-month EMBs by snRNA-seq showed that IVIg treatment reduced cardiac monocyte infiltration and, unlike placebo, prevented the expansion of injured cardiomyocytes. IVIg induced transcriptomic reprogramming across immune cells, fibroblasts, and cardiomyocytes, including diminished myeloid-to-fibroblast signalling with reduced TGF\u03b2 activity, decreased pro-fibrotic and pro-inflammatory pathways and metabolic shifts in cardiomyocytes characterized by enhanced oxidative phosphorylation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with DCM and cardiac B19\u2005V persistence, IVIg added to GDMT correlated with improved long-term clinical outcome. IVIg may attenuate myeloid-driven fibrosis formation and mitigate cardiomyocyte deterioration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag134","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:45:56Z","timestamp":1777031156000},"source":"Crossref","is-referenced-by-count":0,"title":["Improved outcome up to 10 years after intravenous immunoglobulin therapy in patients with dilated cardiomyopathy"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8165-6631","authenticated-orcid":false,"given":"Maurits A","family":"Sikking","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM) , P.Debyelaan 25, Maastricht 6229 HX ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Peisker","sequence":"additional","affiliation":[{"name":"Department of 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Zuyderland Medical Centre , Heerlen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel T H M","family":"Henkens","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maastricht University Medical Centre , Maastricht ,","place":["The Netherlands"]},{"name":"Netherlands Heart Institute (NLHI) , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9228-8045","authenticated-orcid":false,"given":"Anne G","family":"Raafs","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM) , P.Debyelaan 25, Maastricht 6229 HX ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0030-6444","authenticated-orcid":false,"given":"Astrid B M","family":"Heymans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM) , P.Debyelaan 25, Maastricht 6229 HX ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie L V M","family":"Stroeks","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM) , P.Debyelaan 25, Maastricht 6229 HX ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myrurgia A","family":"Abdul Hamid","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maastricht University Medical Centre , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, 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Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM) , P.Debyelaan 25, Maastricht 6229 HX ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5457-3010","authenticated-orcid":false,"given":"Christian","family":"Knackstedt","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM) , P.Debyelaan 25, Maastricht 6229 HX ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"van Paassen","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Immunology, Maastricht University Medical Center , Maastricht ,","place":["The 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