Anti-beta1-adrenoreceptor autoantibodies and myocardial sympathetic nerve activity in chronic heart failure

• Published in: International journal of cardiology 2009-01, Vol.131 (2), p.240-245
• Main Authors: Aso, Shin-ichi, Yazaki, Yoshikazu, Kasai, Hiroki, Takahashi, Masafumi, Yoshio, Taku, Yamamoto, Keiji, Ikeda, Uichi
• Format: Article
• Language: English
• Subjects: Anti-beta1-adrenoreceptor autoantibody; Cardiac sympathetic nervous activity; Cardiovascular; Chronic heart failure; Iodine-123 metaiodobenzylguanidine
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2007.10.029

Abstract Background The autoantibodies stimulate the beta1-adrenoreceptors on cardiac myocytes similar to norepinephrine, and are associated with reduced cardiac function. Iodine-123 metaiodobenzylguanidine (123 I-MIBG) is metabolized similarly to norepinephrine. This study was undertaken to investigate the relationship between cardiac stimulation by anti-beta1-adrenoreceptor autoantibodies and myocardial sympathetic nervous activity in patients with chronic heart failure. Methods We screened for the anti-beta1-adrenoreceptor autoantibodies in 52 patients with chronic heart failure by conducting an enzyme-linked immunosorbent assay, and underwent123 I-MIBG scintigraphy in 27 of the patients. Anterior planar images of123 I-MIBG were obtained 15 min and 3 h after the injection. We determined the heart to mediastinum radioactivity ratio (H/M), and calculated the rate of washout of123 I-MIBG from the heart. Results Patients with New York Heart Association functional class III or IV had higher levels of anti-beta1-adrenoreceptor autoantibodies than those with class I or II ( p < 0.01). The autoantibody level was significantly correlated with delayed H/M ( r = − 0.65, p < 0.001) and washout rate ( r = 0.65, p < 0.001). Sixteen patients with a cardiac event showed higher levels of the autoantibodies ( p < 0.05). Cardiac event-free survival was poorer in patients with the autoantibody levels > 10 U/ml than that < 10 U/ml (log–rank = 12.1, p < 0.001). Conclusion The anti-beta1-adrenoreceptor autoantibodies are closely associated with cardiac sympathetic nervous activity assessed by123 I-MIBG and cardiac event in patients with chronic heart failure.