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. 2023 Oct;10(5):3227-3231.
doi: 10.1002/ehf2.14509. Epub 2023 Sep 8.

Prevalence of anti-beta-1 antibody 6 months after hospitalization for acute heart failure predicts adverse outcome

Caroline Morbach  1   2 , Niklas Beyersdorf  3 , Nicola Moser  1   2 , Dora Pelin  1   2 , Boshra Afshar  3 , Gustavo Ramos  1   2 , Thomas Kerkau  3 , Elisa Kaiser  1   2 , Janna Lamers  1   2 , Jannika Pätkau  1   2 , Floran Sahiti  1   2 , Judith Albert  1   2 , Gülmisal Güder  1   2 , Georg Ertl  1 , Christiane E Angermann  1 , Stefan Frantz  1   2 , Ulrich Hofmann  1   2 , Roland Jahns  4 , Valerie Jahns  5 , Stefan Störk  1   2
Affiliations

Prevalence of anti-beta-1 antibody 6 months after hospitalization for acute heart failure predicts adverse outcome

Caroline Morbach et al. ESC Heart Fail. 2023 Oct.

Abstract

Aims: Agonistic antibodies against neurohumoral receptors can induce cardio-noxious effects by altering the baseline receptor activity. To estimate the prevalence of autoantibodies directed against the beta-1 receptor (b1-AAB) in patients admitted to the hospital for acute heart failure (HF) at (i) baseline and (ii) after 6 months of follow-up (F6) and (iii) after another 12 months of follow-up (i.e. 18 months after index hospitalization), to estimate their prognostic impact on clinical outcome (death or first hospitalization for HF).

Methods and results: In 47 patients, b1-AAB were serially determined in serum samples collected at index hospitalization and at 6 months of follow-up (F6) with a flow cytometry-based assay: median age 71 years (quartiles 60, 80), 23 (49%) women, 24 (51%) HF with preserved ejection fraction. Beta1-AAB were detected in three subjects at index hospitalization (6%), and in eight subjects at F6 (17%). There were no differences apparent between patients with and without b1-AAB at F6 with regard to age, sex, type, duration, or main cause of HF. During the 12 month period following F6 (i.e. up to month 18), eight events occurred. Event-free survival was associated with prevalence of b1-AAB at F6. Compared with patients without b1-AAB at F6, age-adjusted Cox regression indicated a higher event risk in patients harbouring b1-AAB, with a hazard ratio of 8.96 (95% confidence interval 1.81-44.50, P = 0.007).

Conclusions: Our results suggest a possible adverse prognostic relevance of b1-AAB in patients with acute HF, but this observation needs to be confirmed in larger patient collectives.

Keywords: Acute heart failure; Adaptive immune response; Autoantibody; Beta-1; Inflammation.

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Conflict of interest statement

Caroline Morbach reports research cooperation with the University of Würzburg and Tomtec Imaging Systems funded by a research grant from the Bavarian Ministry of Economic Affairs, Regional Development and Energy, Germany; advisory and speaker honoraria as well as travel grants from Amgen, Tomtec, Orion Pharma, Alnylam, AKCEA, Sobi, Alexion, Janssen, Pfizer, Novo Nordisk, and EBR Systems; principal investigator in trials sponsored by Alnylam, AstraZeneca, and Bayer; financial support from the Interdisciplinary Center for Clinical Research—IZKF Würzburg (Advanced Clinician–Scientist Programme).

Niklas Beyersdorf declares reception of a travel grant from Roche Diagnostics GmbH.

Thomas Kerkau has nothing to disclose.

Gustavo Ramos has nothing to disclose.

Floran Sahiti received financial support from IZKF Würzburg (MD/PhD Programme Scholarship).

Judith Albert reports financial support from the Interdisciplinary Center for Clinical Research—IZKF Würzburg (UNION CVD Clinician–Scientist Programme).

Gülmisal Güder reports advisory and speaker honoraria from AstraZeneca, Bayer Vital, Boehringer Ingelheim, Bristol‐Meyers Squibb GmbH, Daiichi Sankyo, Novartis, Orion Pharma GmbH, Pfizer, and Vifor.

Roland Jahns reports several research grants from the German Ministry of Education and Research BMBF FKZ 01ES0816, 01EY1102, FKZ 01EY1712, FKZ 01ZZ2061Y, the Bavarian Centre for Cancer Research (BZKF) and the Interdisciplinary Centre of Research (IZKF), University Hospital Würzburg (Z‐9) as well as (modest) speaker honoraria from Pfizer.

Georg Ertl reports significant honoraria for trial leadership from Abbott and Novartis; has been a consultant for Abbott, Boehringer Ingelheim, Novartis, ResMed, and Vifor (modest); and received significant grant support from Boehringer Ingelheim, Thermo Fisher, Siemens Healthineers, Vifor, and the Federal Ministry of Education and Research.

Christiane E. Angermann reports honoraria for trial leadership from Abbott, Boehringer Ingelheim, and Novartis; has been a consultant for and/or received speaker's honoraria from Abbott, Boehringer Ingelheim, Novartis, ResMed, Springer, and Vifor; and received grant support from Boehringer Ingelheim, Thermo Fisher, Siemens Healthineers, Vifor, and the German Federal Ministry of Education and Research.

Stefan Frantz reports advisory and speaker honoraria as well as travel grants from AMGEN Europe, AstraZeneca, Bayer Vital, Boehringer Ingelheim, Bristol‐Meyers Squibb GmbH, Daiichi Sankyo, MSD, Novartis, Pfizer, Sanofi, Servier, and Vifor.

Ulrich Hofman reports advisory and speaker honoraria as well as travel grants from AstraZeneca, Bayer Vital, Boehringer Ingelheim, Bristol‐Meyers Squibb GmbH, Daiichi Sankyo, MSD, Novartis, Pfizer, and Sanofi.

Stefan Störk reports research grants from the German Ministry of Education and Research, European Union, and University Hospital Würzburg; participation in Advisory Boards of or receiving speaker honoraria from Astra Zeneca, Bayer, Boehringer Ingelheim, Novartis, Pfizer, and Pharmacosmos; principal investigator in trials (co‐)sponsored by AstraZeneca, Bayer, Boehringer‐Ingelheim, Merck, Novartis, and Novo Nordisk.

Valérie Jahns reports a research grant from the German Ministry of Education and Research BMBF FKZ.

Figures

Figure 1
Figure 1
Cox survival curves depicting event‐free survival of patients hospitalized for acute heart failure in the 12 months after the 6 month follow‐up (F6). Red/blue lines denote negative/positive anti‐beta‐1 antibody status at time point F6. CI, confidence interval; HR, hazard ratio.
See this image and copyright information in PMC

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