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European Heart Journal Advance Access published online on June 13, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn268
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Absence of auto-antibodies against cardiac troponin I predicts improvement of left ventricular function after acute myocardial infarction

Florian Leuschner1,{dagger}, Jin Li1,{dagger}, Stefan Göser1, Lars Reinhardt1, Renate Öttl1, Peter Bride1, Jörg Zehelein1, Gabriele Pfitzer2, Andrew Remppis1, Evangelos Giannitsis1, Hugo A. Katus1 and Ziya Kaya1,*

1 Department of Internal Medicine III, Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
2 Institute of Vegetative Physiology, University of Cologne, 50931 Köln, Germany

Received 30 December 2007; revised 25 April 2008; accepted 29 May 2008.

* Corresponding author. Tel: +49 62215639617, Fax: +49 6221565017, Email: ziya.kaya{at}med.uni-heidelberg.de

Aims: Application of antibodies against cardiac troponin I (cTnI-Ab) can induce dilation and dysfunction of the heart in mice. Recently, we demonstrated that immunization with cTnI induces inflammation and fibrosis in myocardium of mice. Others have shown that auto-antibodies to cTnI are present in patients with acute coronary syndrome, but little is known about the clinical relevance of detected cTnI-Ab.

Methods and results: First, anti-cTnI and anti-cTnT antibody titres were measured in sera from 272 patients with dilated- (DCM) and 185 with ischaemic- (ICM) cardiomyopathy. Secondly, 108 patients with acute myocardial infarction (AMI) were included for a follow-up study. Heart characteristics were determined by magnetic resonance imaging 4 days and 6–9 months after AMI. Altogether in 7.0% of patients with DCM and in 9.2% with ICM, an anti-cTnI IgG antibody titre ≥1:160 was measured. In contrast, only in 1.7% of patients with DCM and in 0.5% with ICM, an anti-cTnT IgG antibody titre ≥1:160 was detected. Ten out of 108 patients included in the follow-up study were tested positive for cTnI-Ab with IgG Ab titres ≥1:160. TnI-Ab negative patients showed a significant increase in left ventricular ejection fraction (LVEF) and stroke volume 6–9 months after AMI. In contrast, there was no significant increase in LVEF and stroke volume in TnI-Ab positive patients.

Conclusion: We demonstrate for the first time that the prevalence of cTnI-Abs in patients with AMI has an impact on the improvement of the LVEF over a study period of 6–9 months.

Key Words: Cardiac troponin • Autoantibody • Cardiomyopathy • Myocardial infarction

{dagger} Equally contributed.


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