Key result
The presence of autoantibodies against cardiovascular receptors independently increased the risk of peripartum cardiomyopathy onset (OR 18.786).
Why the study?
Are autoantibodies against cardiovascular receptors (β1R-AABs and M2R-AABs) associated with the pathogenesis and severity of peripartum cardiomyopathy?
Case-Control (n=73)
No
Are autoantibodies against cardiovascular receptors (β1R-AABs and M2R-AABs) associated with the pathogenesis and severity of peripartum cardiomyopathy?
Autoantibodies against β1-adrenergic and M2-muscarinic receptors are significantly elevated in peripartum cardiomyopathy and correlate with worse cardiac function, suggesting a role in its pathogenesis.
Answers are grounded in this paper and cite their sources.
Autoantibody testing may refine peripartum cardiomyopathy risk assessment; leaves open causal role and requires prospective validation before practice change.
BACKGROUND: Peripartum cardiomyopathy (PPCM) is characterized by left ventricular systolic dysfunction and heart failure. However, its pathogenesis is not clear. Our preliminary study revealed that autoantibodies against β1-adrenergic receptors (β1R-AABs) and M2-muscarinic receptors (M2R-AABs) participated in heart failure regardless of primary heart disease. Whether β1R-AABs and M2R-AABs participate in the pathogenesis of PPCM is still unknown. METHODS: Totally 37 diagnosed PPCM patients and 36 normal pregnant women were enrolled in this study. Clinical assessment and 2-dimensional echocardiographic studies as well as the measurement of β1R-AABs or M2R-AABs by enzyme linked immunosorbent assay (ELISA) were performed. RESULTS: The positive rates for β1R-AABs and M2R-AABs were 59.5% (22/37) and 45.9% (17/37) in PPCM patients, and 19.4% (7/36) (P<0.001) and 16.67% (6/36) (P<0.001) in normal pregnant women, respectively. Both β1R-AABs and M2R-AABs had a positive correlation with serum expression level of NT-proBNP, left ventricular dimension and NYHA FC (rs: 0.496-0.892, P<0.01). In addition, a negative correlation between the activity of β1R-AABs and M2R-AABs and LVEF, LVFS was observed (rs: -0.488-0.568, P<0.01). Moreover, autoantibodies against cardiovascular receptors increased the risk of the onset of PPCM (OR = 18.786, 95% confidence interval 1.926-183.262, P = 0.012). CONCLUSIONS: The β1R-AABs and M2R-AABs reveal a significant elevation and are correlated with the increased left ventricular dimension and worse cardiac contraction function. The autoantibodies of cardiovascular receptors are independent risk factors for the onset of PPCM.
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Liu et al. (2014) conducted a case-control in Peripartum cardiomyopathy (PPCM) (n=73). Autoantibodies against cardiovascular receptors (b1R-AABs and M2R-AABs) vs. Absence of autoantibodies / Normal pregnant women was evaluated on Onset of peripartum cardiomyopathy (OR 18.786, 95% CI 1.926-183.262, p=0.012). The presence of autoantibodies against cardiovascular receptors independently increased the risk of peripartum cardiomyopathy onset (OR 18.786).
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