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Background : In patients with dilated cardiomyopathy (DCM) and severe congestive heart failure, immunoadsorption (IA) and subsequent IgG substitution leads to an acute and prolonged hemodynamic improvement. Goal of this study was to investigate the long-term effect of immunoadsorption on morbidity. Methods : In a retrospective analysis of 34 patients (17 patients who have received immunoadsorption therapy and 17 control patients) were included. Inclusion criteria were DCM, left ventricular ejection fraction less than 35%, NYHA classes II–III. The average time after immunoadsorption was 3.0 years (median 2.3 years). Both groups did not differ concerning sex, age, duration of disease, medication, baseline ejection fraction and NYHA class. Results : In patients who have received immunoadsorption (IA) the days of hospitalisation for congestive heart failure per year could be significantly reduced in contrast to the control patients (17.2 days prior to IA, 4.3 days after IA). Even if the procedural days for immunoadsorption were included there was still a significant reduction of hospitalisation if IA therapy was longer than 2.5 years ago. The days of hospitalisation increased gradually with time during the follow up period. IA induced an acute increase in EF (19.8–25.7%, p Conclusion : IA not only leads to an acute hemodynamic improvement in patients with DCM but may also reduce morbidity in these patients during the next 3 years.

We report our results from the analysis of Doppler measurements of breathing-related fluid flow velocity waveforms in the trachea in human fetuses. Our aim was to determine whether, using the proposed method, reproducible patterns can be recognized over the latter half of gestation. Breathing-related tracheal fluid flow velocity of 47 normal fetuses at 20-39 weeks' gestation were analysed. Colour Doppler was used to document 'streaming' of fluid in the trachea, followed by spectral Doppler to record flow velocity waveforms. More than 40 (median 94; range 42-725) continuous breathing cycles (inspiration+expiration) were obtained in each case. Although breathing-related fetal tracheal fluid flow waveforms were found to be highly variable, we were able to distinguish by visual analysis between a regular and an irregular pattern. Among the regular patterns, we further differentiate between a regular symmetric (sinusoidal type) and a regular asymmetric (deep inspiration with expiratory flow retardation) pattern. The regular pattern occurred consistently in all age groups studied and there were no significant (p