Stimulating autoantibodies directed against the cardiac beta1-adrenergic
receptor predict increased mortality in idiopathic cardiomyopathy
S. Stork, V. Boivin, R. Horf, L. Hein, M. Lohse, C. Angermann, and R. Jahns. Am Heart J, 152 (4):
697-704(October 2006)Stork, Stefan Boivin, Valerie Horf, Rudiger Hein, Lutz Lohse, Martin
J Angermann, Christiane E Jahns, Roland Research Support, Non-U.S.
Gov't United States American heart journal Am Heart J. 2006 Oct;152(4):697-704..
Abstract
BACKGROUND: The aim of this study was to estimate the independent
and incremental prognostic value of the presence of stimulating autoantibodies
directed against the human beta1-adrenergic receptor (anti-beta1-AR)
in patients with chronic heart failure. METHODS: One hundred five
antibody-typed chronic heart failure patients with dilated cardiomyopathy
(DCM, n = 65) or ischemic cardiomyopathy (ICM, n = 40) were prospectively
followed for 10.7 +/- 2.5 years. Information on all-cause and cardiovascular
mortality was collected throughout the observation period. RESULTS:
Stimulating anti-beta1-AR were prevalent in 26% (17/65) of patients
with DCM and 13% (5/40) with ICM. All-cause mortality in antibody-positive
patients was 65% in those with DCM and 80% in those with ICM, and
in antibody-negative patients 44% and 49%, respectively. In univariate
and multivariable Cox regression analysis (P < .05), presence of
stimulating anti-beta1-AR was associated with increased all-cause
and cardiovascular mortality risk in DCM but not in ICM. Information
on antibody status improved the prognostic capacity in models containing
already extensive information on clinical profile, Holter electrocardiography,
and invasive hemodynamic measurements (area under the receiver operating
characteristic curve, 0.91; 95% confidence interval, 0.85-0.97; P
< .05 for increase in receiver operating characteristic area). CONCLUSION:
The presence of stimulating anti-beta1-AR autoantibodies independently
predicts increased all-cause and cardiovascular mortality risk in
DCM conferring incremental prognostic value in addition to established
risk predictors. Our data indicate a clinical relevance of stimulating
anti-beta1-AR in DCM and encourage further research into antibody-directed
strategies as a therapeutic principle.
Stork, Stefan Boivin, Valerie Horf, Rudiger Hein, Lutz Lohse, Martin
J Angermann, Christiane E Jahns, Roland Research Support, Non-U.S.
Gov't United States American heart journal Am Heart J. 2006 Oct;152(4):697-704.
%0 Journal Article
%1 Stork2006
%A Stork, S.
%A Boivin, V.
%A Horf, R.
%A Hein, L.
%A Lohse, M. J.
%A Angermann, C. E.
%A Jahns, R.
%D 2006
%J Am Heart J
%K Aged Ambulatory Assessment Autoantibodies/*blood Cardiac Cardiomyopathies/etiology/*immunology/*mortality/physiopathology Cardiomyopathy, Cardiovascular Chronic Cohort Dilated/complications/immunology Disease Diseases/mortality Electrocardiography, Female Hemodynamics Humans Ischemia/complications Low/etiology Male Middle Myocardial Myocardium/*metabolism Output, Predictive Prospective Risk Studies Tests Value beta-1/*immunology/*metabolism of Receptor Adrenergic
%N 4
%P 697-704
%T Stimulating autoantibodies directed against the cardiac beta1-adrenergic
receptor predict increased mortality in idiopathic cardiomyopathy
%U http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16996841
%V 152
%X BACKGROUND: The aim of this study was to estimate the independent
and incremental prognostic value of the presence of stimulating autoantibodies
directed against the human beta1-adrenergic receptor (anti-beta1-AR)
in patients with chronic heart failure. METHODS: One hundred five
antibody-typed chronic heart failure patients with dilated cardiomyopathy
(DCM, n = 65) or ischemic cardiomyopathy (ICM, n = 40) were prospectively
followed for 10.7 +/- 2.5 years. Information on all-cause and cardiovascular
mortality was collected throughout the observation period. RESULTS:
Stimulating anti-beta1-AR were prevalent in 26% (17/65) of patients
with DCM and 13% (5/40) with ICM. All-cause mortality in antibody-positive
patients was 65% in those with DCM and 80% in those with ICM, and
in antibody-negative patients 44% and 49%, respectively. In univariate
and multivariable Cox regression analysis (P < .05), presence of
stimulating anti-beta1-AR was associated with increased all-cause
and cardiovascular mortality risk in DCM but not in ICM. Information
on antibody status improved the prognostic capacity in models containing
already extensive information on clinical profile, Holter electrocardiography,
and invasive hemodynamic measurements (area under the receiver operating
characteristic curve, 0.91; 95% confidence interval, 0.85-0.97; P
< .05 for increase in receiver operating characteristic area). CONCLUSION:
The presence of stimulating anti-beta1-AR autoantibodies independently
predicts increased all-cause and cardiovascular mortality risk in
DCM conferring incremental prognostic value in addition to established
risk predictors. Our data indicate a clinical relevance of stimulating
anti-beta1-AR in DCM and encourage further research into antibody-directed
strategies as a therapeutic principle.
@article{Stork2006,
abstract = {BACKGROUND: The aim of this study was to estimate the independent
and incremental prognostic value of the presence of stimulating autoantibodies
directed against the human beta1-adrenergic receptor (anti-beta1-AR)
in patients with chronic heart failure. METHODS: One hundred five
antibody-typed chronic heart failure patients with dilated cardiomyopathy
(DCM, n = 65) or ischemic cardiomyopathy (ICM, n = 40) were prospectively
followed for 10.7 +/- 2.5 years. Information on all-cause and cardiovascular
mortality was collected throughout the observation period. RESULTS:
Stimulating anti-beta1-AR were prevalent in 26% (17/65) of patients
with DCM and 13% (5/40) with ICM. All-cause mortality in antibody-positive
patients was 65% in those with DCM and 80% in those with ICM, and
in antibody-negative patients 44% and 49%, respectively. In univariate
and multivariable Cox regression analysis (P < .05), presence of
stimulating anti-beta1-AR was associated with increased all-cause
and cardiovascular mortality risk in DCM but not in ICM. Information
on antibody status improved the prognostic capacity in models containing
already extensive information on clinical profile, Holter electrocardiography,
and invasive hemodynamic measurements (area under the receiver operating
characteristic curve, 0.91; 95% confidence interval, 0.85-0.97; P
< .05 for increase in receiver operating characteristic area). CONCLUSION:
The presence of stimulating anti-beta1-AR autoantibodies independently
predicts increased all-cause and cardiovascular mortality risk in
DCM conferring incremental prognostic value in addition to established
risk predictors. Our data indicate a clinical relevance of stimulating
anti-beta1-AR in DCM and encourage further research into antibody-directed
strategies as a therapeutic principle.},
added-at = {2010-12-14T18:12:02.000+0100},
author = {Stork, S. and Boivin, V. and Horf, R. and Hein, L. and Lohse, M. J. and Angermann, C. E. and Jahns, R.},
biburl = {https://www.bibsonomy.org/bibtex/2dbe269e5b2d5a6d272bc61804a4b0758/pharmawuerz},
endnotereftype = {Journal Article},
interhash = {2c4409743ea0b8b142f60852eba9e6d7},
intrahash = {dbe269e5b2d5a6d272bc61804a4b0758},
issn = {1097-6744 (Electronic) 1097-6744 (Linking)},
journal = {Am Heart J},
keywords = {Aged Ambulatory Assessment Autoantibodies/*blood Cardiac Cardiomyopathies/etiology/*immunology/*mortality/physiopathology Cardiomyopathy, Cardiovascular Chronic Cohort Dilated/complications/immunology Disease Diseases/mortality Electrocardiography, Female Hemodynamics Humans Ischemia/complications Low/etiology Male Middle Myocardial Myocardium/*metabolism Output, Predictive Prospective Risk Studies Tests Value beta-1/*immunology/*metabolism of Receptor Adrenergic},
month = Oct,
note = {Stork, Stefan Boivin, Valerie Horf, Rudiger Hein, Lutz Lohse, Martin
J Angermann, Christiane E Jahns, Roland Research Support, Non-U.S.
Gov't United States American heart journal Am Heart J. 2006 Oct;152(4):697-704.},
number = 4,
pages = {697-704},
shorttitle = {Stimulating autoantibodies directed against the cardiac beta1-adrenergic
receptor predict increased mortality in idiopathic cardiomyopathy},
timestamp = {2010-12-14T18:22:42.000+0100},
title = {Stimulating autoantibodies directed against the cardiac beta1-adrenergic
receptor predict increased mortality in idiopathic cardiomyopathy},
url = {http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16996841},
volume = 152,
year = 2006
}