A Pilot Study on the Role of Autoantibody Targeting the β1-Adrenergic Receptor in the Response to β-blocker Therapy for Congestive Heart Failure

被引：46

作者：

Nagatomo, Yuji ^{[1
]}

Yoshikawa, Tsutomu ^{[1
]}

Kohno, Takashi ^{[1
]}

Yoshizawa, Akihiro ^{[2
]}

Baba, Akiyasu ^{[3
]}

Anzai, Toshihisa ^{[1
]}

Meguro, Tomomi ^{[4
]}

Satoh, Toru ^{[1
]}

Ogawa, Satoshi ^{[1
]}

机构：

[1] Keio Univ, Div Cardiol, Dept Med, Sch Med,Shinjuku Ku, Tokyo 1608582, Japan

[2] Ichikawa Gen Hosp, Tokyo Dent Coll, Ichikawa, Japan

[3] Kitasato Inst Hosp, Tokyo, Japan

[4] Tokyo Elect Power Co Hosp, Tokyo, Japan

来源：

JOURNAL OF CARDIAC FAILURE | 2009年 / 15卷 / 03期

关键词：

Autoantibody; carvedilol; dilated cardiomyopathy; metoprolol; IDIOPATHIC DILATED CARDIOMYOPATHY; 2ND EXTRACELLULAR LOOP; BETA(1)-ADRENERGIC RECEPTOR; ISOLATED CARDIOMYOCYTES; AUTOIMMUNE EPITOPE; CARDIAC-FUNCTION; CARVEDILOL; ANTIBODIES; METOPROLOL; TRIAL;

D O I：

10.1016/j.cardfail.2008.10.027

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Autoantibodies directed against the beta 1-adrenergic receptor exert agonistlike actions by inducing receptor uncoupling and cause myocardial damage as well as fatal ventricular arrhythmias. Previous studies have shown that beta-blockers can modulate these actions of the autoantibodies. We investigated the influence of such autoantibodies in patients with congestive heart failure (CHF) receiving beta-blocker therapy. Methods and Results: Eighty-two CHF patients were randomly assigned to treatment with metoprolol or carvedilol for 16 weeks. Autoantibodies were detected in 20 patients (24%) by enzyme-linked immunosorbent assay. Left ventricular function in response to beta-blocker therapy did not differ significantly by the presence of the autoantibody in global analysis. However, changes of the left ventricular end-diastolic dimension (P = .04), end-systolic dimension (P < .01), and ejection fraction on radionuclide ventriculography (P = .02) were significantly larger in autoantibody-positive patients than antibody-negative patients. Changes in the plasma level of brain natriuretic peptide tended to be larger in autoantibody-positive patients (P = .09). The increase of heart rate normalized by the increase of plasma norepinephrine during exercise (an index of adrenergic responsiveness) showed a greater decrease in autoantibody-positive patients than autoantibody-negative patients (P = .035). Conclusion: Our data suggest that beta-blocker therapy might be more effective in CHF patients with autoantibodies targeting the (beta-adrenergic receptor. (J Cardiac Fail 2009:15:224-232)

引用

页码：224 / 232

页数：9