When cardiac antibodies impair cardiac function, their removal would logically be expected to lead to an improvement in the patient's haemodynamic situation. Cardiac antibodies belong to the IgG fraction and can be eliminated by immunoadsorption (IA) therapy. Immunoadsorption has been introduced as a method for treatment of autoimmune processes e.g., Goodpasture's syndrome and lupus erythematodes. This form of therapy has already been successfully applied for treatment of DCM. Several pilot studies have shown that IA improves cardiac function in patients with DCM. The first uncontrolled pilot study disclosed acute beneficial haemodynamic effects of IA in patients with severe heart failure due to DCM. A randomized study followed, to investigate the haemodynamic effects of additional IA therapy for DCM. This study included patients with DCM (NYHA III-IV, LVEF <30%) who were under stable medication. In the IA group, IA was conducted on three consecutive days, with one IA session daily. On the grounds of safety - i.e., to reduce the risk of infection after immunoglobulin depletion - immunoglobulin G was substituted after the last IA session. Immunoadsorption and subsequent IgG substitution (IA/IgG) was repeated for 3 courses at monthly intervals until month 3. In contrast to the control group, patients in the IA/IgG group demonstrated after 3 months a significant increase in cardiac index (CI), paralleled by a similar increase in stroke volume index. A recent study demonstrated that IA/IgG therapy likewise mitigates the inflammatory process in the myocardium of DCM patients. A case-controlled study, performed by others, conducted IA in one course of 5 consecutive days without IgG substitution subsequent to immunoglobulin depletion. This study did not repeat IA during follow-up. In this study, LVEF increased from 22 to 40% one year after IA: a significant gain in contrast to the control group without IA therapy.