Autoantibodies against the second extracellular loop of beta1-adrenergic receptors predict ventricular tachycardia and sudden death in patients with idiopathic dilated cardiomyopathy
Autoantibodies against the second extracellular loop of beta1-adrenergic receptors predict ventricular tachycardia and sudden death in patients with idiopathic dilated cardiomyopathy
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DOI：
10.1016/s0735-1097(00)01109-8
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发表时间：
2001-02-01
影响因子：
24
通讯作者：
Ogawa, S
中科院分区：
文献类型：
--
作者：
Iwata, M;Yoshikawa, T;Ogawa, S
我们试图确定针对特发性扩张型心肌病（IDC）患者β(1)-肾上腺素能受体（ARs）第二细胞外环的自身抗体的临床和长期预后意义。虽然在IDC患者中发现了针对多种β -ARs结构域的自身抗体，但只有一种针对β -ARs的第二细胞外结构域的亚群对人β -ARs发挥内在的类似交感神经的作用。提示自身抗体参与了ldl的病理生理过程，并可能影响患者的长期预后。方法采用合成β (1)-ARs结构域对应肽段，采用酶联免疫吸附法筛选104例IDC患者血清中抗β (1)-ARs细胞外第二环的自身抗体。通过多因素分析评估自身抗体与临床变量和长期预后的关系。结果40例（38%）患者检出自身抗体。自身抗体阳性患者比抗体阴性患者多灶性室性早搏（p < 0.01）和室性心动过速（p < 0.01）更为常见，尽管心功能和神经激素水平没有差异。存在自身抗体（p = 0.001）和低左心室射血分数（LVEF）
Objectives We sought to define the clinical and long-term prognostic implications of autoantibodies that act against the second extracellular loop of beta(1)-adrenergic receptors (ARs) in patients with idiopathic dilated cardiomyopathy (IDC).Background Although autoantibodies directed against various domains of beta-ARs are found in patients with IDC, only a subgroup against the second extracellular domain of beta(1)-ARs exerts intrinsic sympathomimetic-like actions on human beta-ARs. It is suggested that the autoantibodies take part in the pathophysiology of LDC and may affect long-term prognosis of patients with this disorder.Methods Sera from 104 patients with IDC were screened for autoantibodies that act against the second extracellular loop of beta(1)-ARs by enzyme-linked immunosorbent assay, using a synthetic peptide corresponding to the domain. Relations of the autoantibodies to clinical variables and long-term prognosis were assessed by multivariate analysis.Results Autoantibodies were detected in 40 patients (38%). Multifocal ventricular premature contractions (p < 0.01) and ventricular tachycardia (VT; p < 0.01) were more common in autoantibody-positive than in antibody-negative patients, although no differences in cardiac function or neurohormonal levels were demonstrated. The presence of autoantibodies (p = 0.001) and a low left ventricular ejection fraction (LVEF