The correlation between peripartum cardiomyopathy and autoantibodies against cardiovascular receptors

• Published in: PloS one Vol. 9; no. 1; p. e86770
• Main Authors: Liu, Jiamei, Wang, Yidan, Chen, Mulei, Zhao, Wenshu, Wang, Xin, Wang, Hua, Zhang, Zhiyong, Zhang, Juan, Xu, Lin, Chen, Jin, Yang, Xinchun, Zhang, Lin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 23.01.2014; Public Library of Science (PLoS)
• Subjects: Acetylcholine receptors (muscarinic); Adrenergic receptors; Adult; Autoantibodies; Autoantibodies - blood; Autoimmunity; Biology; Biomarkers - blood; Cardiology; Cardiomyopathy; Cardiomyopathy, Dilated - blood; Cardiomyopathy, Dilated - diagnosis; Cardiovascular disease; Cardiovascular diseases; Case-Control Studies; Confidence intervals; Contraction; Coronary artery disease; Correlation; Diagnosis; Echocardiography; Enzyme-linked immunosorbent assay; Enzymes; Female; Health risks; Heart; Heart diseases; Heart failure; Heart rate; Hospitals; Humans; Medical research; Medicine; Morphology; Myocardial diseases; Pathogenesis; Patients; Peripartum Period; Pregnancy; Pregnancy Complications, Cardiovascular - blood; Pregnancy Complications, Cardiovascular - diagnosis; Pregnant women; Receptor mechanisms; Receptor, Muscarinic M2 - blood; Receptors; Receptors (physiology); Receptors, Adrenergic, beta-1 - blood; Risk analysis; Risk factors; Ventricle; Ventricular Function, Left; Womens health; Beijing China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0086770

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. 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. 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). 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.