The Correlation And The Significances Of Serum Autoantibodies Against Theβ3-adrenergic Receptor With Malignant Arrhythmia In Heart Failure Patients

Object: To detect whether serum autoantibodies against the β3-adrenergic receptor with malignantarrhythmia are related in chronic heart failure patients (CHF). Meanwhile the effect and interactionof autoantibodies against the β1/β2-adrenergic receptor and autoantibodies against the L-typeCa2+channel with malignant arrhythmia should be discussed.Methods: According to the result of24-hour dynamic electrocardiogram examination CHF203patientsfrom the department of Cardiology and Geriatrics between2012to2013.96patients were dividedinto the malignant arrhythmia group and107patients as control group. Cardiac function wasexamined by echocardiographyand autoantibodies against the β1/β2/β3-adrenergic receptor andL-type Ca2+channel’s by enzyme linked immune assay. Records clinical data of patients werecollected. By multiple logistic regressions the risk factors were analyzed on malignant arrhythmiaof CHF.Results:1. Malignant arrhythmia group has higher cardiac functional grading than contrast group, Thedifference has statistical significance（P<0.05）；Ventricular arrhythmia is the main type of malignantarrhythmia. The rate of ventricular arrhythmia is63.5%（61/96）,and atrial arrhythmia is26%(25/96),Conducted arrhythmias is10.4%(10/96).2. In heart failure patients, positive for autoantibodies against β-1-AR with76cases, the positive rate is37.4%.The group divided by NYHA classification discovered that with increasing of cardiac functionclassification, positive rate increases. The difference has statistical significanc（eP<0.05）.In malignantarrhythmia group，positive for autoantibodies against β-1-AR with44cases, the positive rate is45.83%.In contrast group has44positive cases,which rate is29.9%. Malignant arrhythmia grouphas higher positive rate than contrast group, The difference has statistical significance（P<0.05）3. In heart failure patients, positive for autoantibodies against β-2-AR with76cases, the positive rate is37.4%.The group divided by NYHA classification discovered that with increasing of cardiac functionclassification, positive rate increases. The difference has statistical significanc（eP<0.05）.In malignantarrhythmia group，positive for autoantibodies against β-2-AR with46cases, the positive rate is47.91%.In contrast group has37positive cases,which rate is34.58%. malignant arrhythmia grouphas higher positive rate than contrast group, but the difference hasn’t statistical significance（P>0.05）.4. In heart failure patients, positive for autoantibodies against β3-AR with94cases, the positive rate is46.3%.The group divided by NYHA classification discovered that with increasing of cardiac functionclassification, positive rate increases. The difference has statistical significanc（eP<0.05）.In malignantarrhythmia group， positive for autoantibodies against β3-AR with52cases, the positive rate is54.17%.In contrast group has42positive cases,which rate is39.25%. Malignant arrhythmia grouphas higher positive rate than contrast group, The difference has statistical significance（P<0.05）.5. In heart failure patients, positive for autoantibodies against the L-type Ca2+channel with66cases,the positive rate is32.51%. Positive rate of group divided by NYHA classification Hasn’t statisticalsignificance（P>0.05）.In malignant arrhythmia group，positive for autoantibodies against the L-typeCa2+channel with37cases, the positive rate is38.54%.In contrast group has29positivecases,which rate is27.10%. Malignant arrhythmia group has higher positive rate than contrast group, but the difference hasn’t statistical significance（P>0.05）.6. The result of regression analysis demonstrated that3risk factors were related to malignant arrhythmiaincluding NYHA （OR=6.019）， Etiology of heart failure (OR=5.353) autoantibodies againstβ3-AR(0R=3.919)Conclusion:1. The positive rate of auto antibodies against β1-AR and β3-AR in malignant arrhythmiagroup were all higher than contrast group.2. The positive rate of autoantibodies against β1/β2/β3-AR in malignant arrhythmia group increaseswith increasing of cardiac function classification, deterioration of cardiac function, Ventriculararrhythmia is the main type of malignant arrhythmia; cardiac function classification,Autoantibodiesagainst β3-AR are related for malignant arrhythmia occurred in HF.