Heart Failure with Recovered Ejection Fraction: EGPA-Associated Cardiomyopathy Treated with Benralizumab
- 1Department of Heart Failure and Transplant, Mayo Clinic Florida, Jacksonville, FL 32224, USA
- 2Department of Neurology, Mayo Clinic Florida, Jacksonville, FL 32224, USA
- 3Department of Infectious Diseases, Mayo Clinic Florida, Jacksonville, FL 32224, USA
Abstract
Background: We report a case to demonstrate that targeted eosinophil depletion with Benralizumab (anti-IL-5 receptor α therapy) can induce the complete functional and structural reversal of advanced EGPA-associated cardiomyopathy. Case Presentation: A 56-year-old woman with a decade-long history of EGPA presented with progressive nonischemic dilated cardiomyopathy and a nadir ejection fraction of 25–30%. Cardiac MRI demonstrated diffuse nonischemic late gadolinium enhancement consistent with eosinophil-mediated myocardial injury. Despite the optimization of guideline-directed medical therapy, complete recovery was not achieved until benralizumab was initiated. Following biologic therapy, the ejection fraction recovered to 50% and severe mitral regurgitation regressed to mild. The exercise capacity was preserved throughout, with a peak VO2 of 117% and 111% of predicted before and after biologic therapy, respectively. The patient remains in NYHA Class I at the one-year follow-up. Discussion: We describe a case with EGPA-associated non-ischemic cardiomyopathy treated with benralizumab achieving the complete recovery of ventricular function and achieving the complete independence of steroid therapy. Conclusions: This case emphasizes the importance of identifying the inflammatory etiology of cardiomyopathy, optimizing GDMT systematically, and considering targeted biologic therapy directed at the underlying disease.
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BibTeX
@article{bangari2026heart,
title = {{Heart Failure with Recovered Ejection Fraction: EGPA-Associated Cardiomyopathy Treated with Benralizumab}},
author = {Laxmi Raj Bangari and Yugant Khand and Vidit Yadav and Aarti Desai and Andrea Muniz and Jose Ruiz and Jose Nativi-Nicolau and Juan Leoni and Parag Patel and Rohan Goswami},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208057},
url = {https://www.mdpi.com/2077-0383/15/20/8057},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Heart Failure with Recovered Ejection Fraction: EGPA-Associated Cardiomyopathy Treated with Benralizumab
AU - Laxmi Raj Bangari
AU - Yugant Khand
AU - Vidit Yadav
AU - Aarti Desai
AU - Andrea Muniz
AU - Jose Ruiz
AU - Jose Nativi-Nicolau
AU - Juan Leoni
AU - Parag Patel
AU - Rohan Goswami
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208057
UR - https://www.mdpi.com/2077-0383/15/20/8057
AB - Background: We report a case to demonstrate that targeted eosinophil depletion with Benralizumab (anti-IL-5 receptor α therapy) can induce the complete functional and structural reversal of advanced EGPA-associated cardiomyopathy. Case Presentation: A 56-year-old woman with a decade-long history of EGPA presented with progressive nonischemic dilated cardiomyopathy and a nadir ejection fraction of 25–30%. Cardiac MRI demonstrated diffuse nonischemic late gadolinium enhancement consistent with eosinophil-mediated myocardial injury. Despite the optimization of guideline-directed medical therapy, complete recovery was not achieved until benralizumab was initiated. Following biologic therapy, the ejection fraction recovered to 50% and severe mitral regurgitation regressed to mild. The exercise capacity was preserved throughout, with a peak VO2 of 117% and 111% of predicted before and after biologic therapy, respectively. The patient remains in NYHA Class I at the one-year follow-up. Discussion: We describe a case with EGPA-associated non-ischemic cardiomyopathy treated with benralizumab achieving the complete recovery of ventricular function and achieving the complete independence of steroid therapy. Conclusions: This case emphasizes the importance of identifying the inflammatory etiology of cardiomyopathy, optimizing GDMT systematically, and considering targeted biologic therapy directed at the underlying disease.
SN - 2077-0383
ER -