Abstract 13741: Clinical Value of the Detection of Autoantibodies Against β1, β2 and α1 Adrenergic Receptors in Patients With Heart Failure

Background: Metoprolol and carvedilol are the β-blockers most often used in the management of patients with heart failure (HF), and the choice of drug is still unclear. Autoantibodies against β1, β2 and α1 adrenergic receptors (anti-β1-AR, anti-β2-AR and anti-α1-AR) participate in the pathology of HF. The purpose of the current study is to determine anti-β1-AR, anti-β2-AR and anti-α1-AR may be association with carvedilol treatment in HF patients. Methods: Synthetic β1, β2 and α1 adrenoreceptors peptides served as the target antigen. ELISA was used to screen the sera of 267 HF patients, which were divided into different groups based on their autoantibodies reactively. Echocardiography was performed between carvedilol therapy. Results: Final analysis covered 137 patients, including 65 patients with three autoantibodies and 72 negative. The frequency and geometric mean titer of anti-β1-AR, anti-β2-AR and anti-α1-AR were significantly lower in the positive group after 6 months of carvedilol (all P<0.01, from 100% to 57%, 50%, 49% and from 1:118, 1:138, 1:130 to 1:72, 1:61,1:67 respectively). Of these, 28 patients showed no autoantibodies. Both groups showed improvement left ventricular remodeling and function by carvedilol in combination with standard treatment regime for six months (all P<0.01). However, the 68 patients with three antibodies improved more obviously than 72 negative patients (P<0.01). Conclusion: Carvedilol treatment significantly decreased the frequency and geometric mean titer in patients with three autoantibodies, even to complete ablation, and with more improvement in cardiac function and remodeling. Three autoantibodies may be useful biomarker of over-activation of the sympathetic nerves system for clinical medication.