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Objective To determine the association between autoantibodies toG-protein-coupled receptors with effect on the cardiovascular system and thecardiac biomarker N-terminal pro-brain natriuretic peptide reflecting heartfunction in Gravesʼ disease.  Design and Methods Sixty premenopausal women with Graves’disease were analyzed for IgG autoantibodies againstβ1-adrenergic, muscarinic acetylcholine type 2 andangiotensin II type 1 receptors using enzyme-linked immunosorbent assaysbased on cell membranes overexpressing receptors in their nativeconformations. N-terminal pro-brain natriuretic peptide and heart symptomswere analyzed in hyperthyroidism and after 7.5 months of antithyroidtreatment. Matched thyroid healthy controls were also assessed.  Results Serum levels of antibodies against theβ1-adrenergic and the muscarinic acetylcholine type 2receptors were higher in hyperthyroid patients than in controls (medianβ1-adrenergic receptor antibodies 1.9 [IQR1.3–2.7] vs. 1.1 [0.8–1.7] μg/mL,P&lt;0.0001; muscarinic acetylcholine type 2 receptor 20.5[14.0–38.3] vs. 6.0 [3.2–9.9] U/mL,P&lt;0.0001). These antibodies decreased in euthyroidism(P&lt;0.01), but were still higher than in controls(P&lt;0.01). Angiotensin II type 1 receptor levels did notdiffer. N-terminal pro-brain natriuretic peptide was higher inhyperthyroidism (240 [134–372] vs. &lt;35[&lt;35–67] ng/L, P&lt;0.0001), normalizedafter treatment and did not correlate with autoantibodies.  Conclusion Autoantibodies against the β1-adrenergicand the muscarinic acetylcholine type 2 receptors were increased inGraves’ patients, decreased with treatment, but did not correlatewith cardiac function. However, an autoimmune effect on the heart cannot beexcluded in subpopulations, as the functional properties of the analyzedantibodies remain to be determined.

β1-adrenergic and Muscarinic Acetylcholine Type 2 Receptor Antibodies are Increased in Graves’ Hyperthyroidism and Decrease During Antithyroid Therapy