The Effects of Hydroxychloroquine in Patients with Inflammatory Cardiomyopathy

Inclusion criteria:

1. Male or female patient aged from 18 to 80 years;

2. Left ventricular dysfunction [left ventricular ejection fraction (LVEF) <50%]diagnosed by echocardiography (Simpson's biplane) within 30 days beforerandomization;

3. Chronic heart failure (lasting >6 months) unresponsive to conventional supportivetherapy;

4. High-sensitivity cardiac Troponin I (hs-cTnI) >26.2 pg/mL and N-terminal-pro-B-typenatriuretic peptide (NT-proBNP) >169pg/mL;

5. Suffered from confirmed fulminant myocarditis in the past;

6. Diagnosed with chronic inflammatory cardiomyopathy confirmed by myocardial biopsy1;

7. Absence of cardiotropic viruses at polymerase chain reaction analysis;

8. Volunteer for the study and written informed consent;

Exclusion criteria:

1. Age <18 or >80 years;

2. Acute myocardial infarction occurred within the past month;

3. Subjects who have undergone cardiac surgery or cerebrovascular accidents within 6months;

4. Preparing for heart transplantation;

5. With malignant arrhythmias such as long QT syndrome;

6. Pregnancy or lactation;

7. Have participated in any drug clinical trial within the three months;

8. Presence of contraindications to prednisolone and/or hydroxychloroquine (includinghypersensitivity to prednisone or hydroxychloroquine, mainly untreated systemicinfection, uncontrolled diabetes, poorly controlled endocrine diseases,osteoporosis, gastric or duodenal ulcer, uncontrolled hypertension, leukocytopenia (leukocyte counts < 4×109/L), neutropenia (neutrophils < 1.5×109/L),thrombocytopenia (platelet levels < 130×109/L), anemia (hemoglobin levels < 11g/dL).

9. Confirmed or possible systemic inflammatory diseases;

10. On the brink of death or life expectancy of less than 1 year;

11. Drug or alcohol abuse;

12. cannot persist in taking medication due to various reasons;

13. Inability to provide informed consent.