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Cardiac β 1 ‐adrenoceptor autoantibodies in human heart disease: rationale and design of the E tiology, Ti tre‐ C ourse, and S urvival (ETiCS) Study
Author(s) -
Deubner Nikolas,
Berliner Dominik,
Schlipp Angela,
Gelbrich Götz,
Caforio Alida L.P.,
Felix Stephan B.,
Fu Michael,
Katus Hugo,
Angermann Christiane E.,
Lohse Martin J.,
Ertl Georg,
Störk Stefan,
Jahns Roland
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq072
Subject(s) - medicine , autoantibody , heart failure , autoimmunity , myocarditis , heart disease , pathophysiology , dilated cardiomyopathy , myocardial infarction , cardiomyopathy , cardiology , disease , immunology , antibody
Aims Evidence for a pathophysiologic relevance of autoimmunity in human heart disease has substantially increased over the past years. Conformational autoantibodies stimulating the cardiac β1‐adrenoceptor (β1‐aabs) are considered of importance in heart failure development and clinical pilot studies have shown their prognostic significance in human ‘idiopathic’ cardiomyopathy. Methods We recently developed a novel highly sensitive fluorescence‐based functional assay to detect stimulating β1‐aabs. We will use this method to assess Etiology, Titre‐ C ourse, and effect on Survival (ETiCS) of β1‐aabs in a prospective multicentre study with serial follow‐up of patients after a first acute myocarditis or myocardial infarction. Several European core laboratories will jointly study the hypothesis that both disorders may trigger autoimmune reactions leading to the generation of β1‐aabs and/or other heart‐directed aabs. Further, sera from healthy controls and well‐characterized patient cohorts with dilated, ischaemic, or hypertensive cardiomyopathy will be analysed retrospectively for β1‐aab prevalence, incidence, persistence, and/or clearance. Conclusion ETiCS is so far the largest clinical diagnostic study projected to address cardiac autoimmunity. It attempts to unravel the pathophysiology of cardiac autoantibody formation and persistence/clearance. ETiCS will enhance current knowledge on autoimmunity in human heart disease and promote endeavours to develop novel therapies targeting cardiac aabs.