Copyright © 1995 by the European Society of Cardiology.
© 1995 The European Society of Cardiology
Organ-specific cardiac autoantibodies in dilated cardiomyopathy—an update
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* Department of Cardiology, University of Padua Italy
Department of Cardiological Sciences, St George's Hospital Medical School London, U.K.
Department of Immunology, London Hospital Medical College London, U.K.
Alida L. P. Caforio, MD, PhD. Department of Cardio-logical Sciences. St George's Hospital Medical School. Cranmer Terrace. London SW17 ORE. UK.
Autoimmune disease is characterized by the presence of organ-and disease-specific autoantibodies in patients and first degree relatives; antibody detection may precede disease onset by several years. We investigated potential involvement of organ-specific autoimmunity in dilated cardiomyopathy (DCM). Using indirect immunofluorescence and absorption studies, organ- and disease-specific IgG cardiac antibodies were found in one-third of DCM patients. Antibody status at diagnosis was associated with better exercise capacity; at 1 -year follow-up two-thirds of antibody-positive patients became negative. These findings suggest that antibodies are early markers; their absence in the majority of patients at diagnosis may relate to long-standing pre-clinical DCM. Antibody screening was performed in asymptomatic DCM relatives, 177 from 33 families with >1 affected individual (familial DCM) and 165 from 31 pedigrees with non-familial DCM. Antibodies were detected in 37 (58%) pedigrees and were more common among relatives than in normals (20% vs 3-5% P = 00001). Antibody-positive relatives were younger, had larger left ventricular end-systolic dimension and reduced % fractional shortening compared to antibody-negative relatives. These findings provide evidence for autoimmunity in a subset (58%) including both familial and non-familial DCM; cardiac-specific antibodies may identify relatives at risk of developing DCM.
Key Words: Myocardial disease • primary • myosim • autoimmune disease • antibodies