Elevated Serum Levels of IgG4 in Patients with Heart Failure with Reduced Ejection Fraction: A Prospective Controlled Study

• Published in: Biology (Basel, Switzerland) Switzerland), 2022-08, Vol.11 (8), p.1168
• Main Authors: Volodarsky, Igor, Anton, Anamaria, Zilberman, Liaz, Fugenfirov, Irina, Neumark, Eran, Malnick, Stephen, Levy, Yair, George, Jacob, Goland, Sorel
• Format: Article
• Language: English
• Subjects: Aneurysms; Blood levels; Cardiac muscle; Cardiomyopathy; Cardiovascular disease; Cardiovascular diseases; Congestive heart failure; Coronary artery; Coronary artery disease; Dilated cardiomyopathy; Ejection fraction; Fibrosis; Heart diseases; Heart failure; Hypertension; idiopathic dilated cardiomyopathy; IgG4 related disease; Immunoglobulin G; Inflammation; Ischemia; ischemic cardiomyopathy; Medical imaging; Peptides; Serum levels; Ventricle
• ISSN: 2079-7737; 2079-7737
• DOI: 10.3390/biology11081168

(1) Background: Immunoglobulin gamma subclass 4 (IgG4) is a serum protein belonging to the immunoglobulin superfamily. It has a central role in certain immune-mediated conditions defined as IgG4-related disease. There is a paucity of data regarding the potential association of IgG4 and cardiovascular diseases. Our aim is to study the serum levels of IgG4 in patients with ischemic and non-ischemic dilated cardiomyopathy (DCM). (2) Methods: patients with ischemic and non-ischemic DCM were included in this study. Non-ischemic DCM was defined as a left ventricular ejection fraction (LVEF) < 40% without coronary artery disease (CAD). Ischemic DCM was defined as a LVEF < 40% and proven CAD. The serum concentrations of IgG4 were measured by turbidimetry. (3) Results: Overall 98 patients with cardiomyopathy had significantly higher levels of IgG4 compared with the control group (77.4 ± 64.0 vs. 50.3 ± 28.8 mg/dL, p < 0.01). Although there was no difference in the total IgG levels in patients with ischemic DCM, the serum concentrations of IgG4 were significantly higher than the corresponding values in the control group (89.8 ± 67.3 vs. 50.3 ± 28.8 mg/dL; interquartile ranges: 40.4−126.5 vs. 31.8−66.8 mg/dL, p < 0.01). This was altered by gender and smoking. (4) Conclusions: The patients with ischemic DCM had increased serum concentrations of IgG4. Future studies are warranted to explore the potential role of an IgG4-mediated process in patients with heart failure with reduced LVEF.