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The predictive values of beta 1 ‐adrenergic and M 2 muscarinic receptor autoantibodies for sudden cardiac death in patients with chronic heart failure
Author(s) -
Pei Juanhui,
Li Ning,
Chen Jingzhou,
Li Xian,
Zhang Yinhui,
Wang Zengwu,
Zhang Ping,
Cao Kejiang,
Pu Jielin
Publication year - 2012
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/hfs082
Subject(s) - medicine , heart failure , cardiology , ejection fraction , autoantibody , hazard ratio , sudden cardiac death , dilated cardiomyopathy , cardiomyopathy , sudden death , confidence interval , immunology , antibody
Aims Clinical and animal studies suggest that beta 1 ‐adrenergic and M 2 muscarinic receptor autoantibodies (beta 1 ‐AAbs and M 2 ‐AAbs) play important roles in the pathophysiological process of chronic heart failure (CHF). Removal of these autoantibodies improved haemodynamic parameters and left ventricular ejection fraction patients with CHF. The goal of this project is to evaluate whether beta 1 ‐AAbs and M 2 ‐AAbs predict prognosis and sudden cardiac death (SCD) in CHF. Methods and results A total of 2062 patients with CHF and 824 control subjects were recruited. Beta 1 ‐AAbs and M 2 ‐AAbs were detected by the enzyme‐linked immunosorbent assay (ELISA) method, and the correlation between these autoantibodies and the prognosis of CHF was analysed. During a median follow‐up period of 36 months (0.40 ± 65 months), 379 (21.56%) cases died—164 had dilated cardiomyopathy (DCM) and 215 had ischaemic cardiomyopathy (ICM). Of these, SCD occurred in 69 cases (40.37%) of DCM and in 84 cases (39.07%) of ICM. Positivity for beta 1 ‐AAbs in DCM and ICM was significantly higher than for the controls (8.1% and 8.25% v.s 2.2%, both P < 0.01). However, positive M 2 ‐AAbs did not show any statistical difference between the three groups. Cox regression analysis revealed that positive beta 1 ‐AAbs were associated with higher mortality in CHF and that it predicted SCD for DCM [hazard ratio (HR) 4.51, 95% confidence interval (CI) 2.405–8.471] and ICM (HR 3.749, 95% CI 2.389–5.884) patients, but not non‐SCD (NSCD) patients. Conclusions The rates of positive beta 1 ‐AAbs were higher in CHF patients than in the controls. Positive beta 1 ‐AAbs might serve as an independent predictor for SCD in patients with CHF.