Abstrakt
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.
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.
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.
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.