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. 2020 Jun;17(6):305-312.
doi: 10.11909/j.issn.1671-5411.2020.06.002.

Clinical value of detecting autoantibodies against β1-, β2,- and α1-adrenergic receptors in carvedilol treatment of patients with heart failure

Dong-Yan Hou  1 , Lin Xu  1 , Zhi-Yong Zhang  1 , Xiao-Rong Xu  1 , Xin Wang  1 , Juan Zhang  1 , Jia-Mei Liu  1 , Hua Wang  1 , Jin Chen  1 , Lin Zhang  1
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Clinical value of detecting autoantibodies against β1-, β2,- and α1-adrenergic receptors in carvedilol treatment of patients with heart failure

Dong-Yan Hou et al. J Geriatr Cardiol. 2020 Jun.

Abstract

Objective: To determine the possible association of anti-β1-adrenergic receptors (anti-β1-AR), anti-β2-AR and anti-α1-AR with carvedilol treatment in patients with heart failure (HF).

Methods: A total of 267 HF patients were prospectively enrolled. Blood samples were measured by an enzyme-linked immunosorbent assay. All of the patients received carvedilol for their HF. Each patient was followed up for six months and their cardiac function was measured.

Results: The final analysis encompassed 137 patients comprising 65 patients with three autoantibodies (positive group) and 72 patients without all three autoantibodies but with one or two autoantibodies (negative group). The frequency and geometric mean titer of anti-β1-AR, anti-β2-AR, and anti-α1-AR were significantly lower in the group without all three autoantibodies after six months of carvedilol treatment (all P < 0.01; from 100% to 57%, 50%, and 49%, respectively; and from 1: 118, 1: 138, and 1: 130 to 1: 72, 1: 61, and 1: 67, respectively). Furthermore, 28 patients in the positive group demonstrated complete ablation of autoantibodies. In addition, left ventricular remodelling and function was significantly improved by the use of carvedilol combined with the standard treatment regime for six months in the positive group (P < 0.01) when compared to the negative group (P < 0.05).

Conclusions: Carvedilol treatment significantly decreases frequency and geometric mean titer in patients with all three autoantibodies, even up to complete ablation, and significantly improved cardiac function and remodelling. The effect of carvedilol is probably correlated to the presence of all three autoantibodies.

Keywords: Adrenergic receptors; Autoantibodies; Cardiac function; Carvedilol; Heart failure.

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Figures

Figure 1.
Figure 1.. The distribution of the three autoantibodies in patients with heart failure.
Figure 2.
Figure 2.. The comparison of echocardiographic data after carvedilol treatment.
In patients with heart failure, after six months of treatment with carvedilol, the LVEDD and LVESD decreased more compared to those in the group of patients without all three autoantibodies. In addition, the LVEF changed more in the group with all three autoantibodies. The group of patients with all three autoantibodies exhibited a significant improvement in response to the carvedilol therapy. #P < 0.01 vs. baseline, *P < 0.05 vs. Control. LVEDD: left ventricular end-diastolic dimension; LVESD: left ventricular end-systolic dimension; LVEF: left ventricular ejection fraction.
Figure 3.
Figure 3.. The trends of the LVEDD, LVESD, and LVEF for the two groups after one to six months post-baseline.
LVEDD: left ventricular end-diastolic dimension; LVESD: left ventricular end-systolic dimension; LVEF: left ventricular ejection fraction.
See this image and copyright information in PMC

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