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Controlled Clinical Trial
. 2015 Sep;40(6):892-7.
doi: 10.1007/s00059-015-4308-1. Epub 2015 May 5.

Recent-onset Dilated Cardiomyopathy Associated With Borrelia Burgdorferi Infection

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Controlled Clinical Trial

Recent-onset Dilated Cardiomyopathy Associated With Borrelia Burgdorferi Infection

Petr Kuchynka et al. Herz. .

Abstract

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.

Keywords: Antibiotics; Borrelia burgdorferi; Dilated cardiomyopathy; Endomyocardial biopsy; Lyme disease.

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