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Basic Research in Cardiology
Published in: Basic Research in Cardiology 1/2011

01-01-2011 | Original Contribution

Impact of troponin I-autoantibodies in chronic dilated and ischemic cardiomyopathy

Authors: Andreas O. Doesch, Susanne Mueller, Manfred Nelles, Mathias Konstandin, Sultan Celik, Lutz Frankenstein, Stefan Goeser, Ziya Kaya, Achim Koch, Christian Zugck, Hugo A. Katus

Published in: Basic Research in Cardiology | Issue 1/2011

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Abstract

The aim of this study was to investigate the prognostic value of circulating troponin I (TNI)-autoantibodies in plasma of patients with chronic heart failure. Sera of 390 heart failure patients were tested for the presence of anti-TNI antibodies by enzyme-linked immunosorbent assay (ELISA), including 249 (63.8% of total) patients with dilated cardiomyopathy (DCM) and 141 (36.2% of total) patients with ischemic cardiomyopathy (ICM). A total of 72 patients (18.5% of total) were female and 318 (81.5% of total) were male. Mean patient age was 54.6 ± 11.3 years and mean follow-up time was 3.8 ± 3.2 years. TNI-autoantibodies (titer of ≥1:40) were detected in 73 out of 390 patients (18.7% of total). In TNI-autoantibody positive patients mean left ventricular ejection fraction (LVEF) was 27.6 ± 5.8%, compared to 25.8 ± 5.9% in TNI-autoantibody negative patients, P = 0.03. The combined end-point of death (n = 118, 30.3% of total) or heart transplantation (HTX) (n = 44, 11.3% of total) was reached in 162 patients (41.5% of total). Kaplan–Meier analysis demonstrated superior survival (combined end-point of death or HTX) in patients with DCM versus ICM (P = 0.0198) and TNI-autoantibody positive patients versus TNI-autoantibody negative patients (P = 0.0348). Further subgroup analysis revealed a favorable outcome in TNI-positive patients with heart failure if the patients suffered from DCM (P = 0.0334), whereas TNI-autoantibody status in patients with ICM was not associated with survival (P = 0.8486). In subsequent multivariate Weibull-analysis, a positive TNI serostatus was associated with a significantly lower all-cause mortality in DCM patients (P = 0.0492). The presence of TNI-autoantibodies in plasma is associated with an improved survival in patients with chronic DCM, but not ICM. This might possibly indicate a prophylactic effect of TNI-autoantibodies in this subgroup of patients, encouraging further studies into possible protective effects of antibodies against certain cardiac target structures.

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Metadata
Title
Impact of troponin I-autoantibodies in chronic dilated and ischemic cardiomyopathy
Authors
Andreas O. Doesch
Susanne Mueller
Manfred Nelles
Mathias Konstandin
Sultan Celik
Lutz Frankenstein
Stefan Goeser
Ziya Kaya
Achim Koch
Christian Zugck
Hugo A. Katus
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Basic Research in Cardiology / Issue 1/2011
Print ISSN: 0300-8428
Electronic ISSN: 1435-1803
DOI
https://doi.org/10.1007/s00395-010-0126-z

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