Cited by 197Viral Infections and Immunology ResearchCardiac Fibrosis and RemodelingTakotsubo Cardiomyopathy and Associated Phenomena

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Antimyosin autoantibodies are associated with deterioration of systolic and diastolic left ventricular function in patients with chronic myocarditis

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Lauer, Bernward, Schannwell, Mira, Kühl, Uwe, Strauer, Bodo-Eckhard, Schultheiss, Heinz-Peter·2000·Journal of the American College of Cardiology

Abstract

Objectives The study evaluates the clinical course and the development of systolic and diastolic left ventricular function in patients with chronic myocarditis with or without autoantibodies against cardiac myosin. Background Patients with myocarditis often show autoantibodies against cardiac myosin. The clinical and pathophysiologic significance of these antimyosin autoantibodies (AMAAB) is yet unknown. The results from studies comparing the clinical course and the development of left ventricular function in patients with chronic myocarditis with or without AMAAB are not yet available. Methods Thirty-three patients with biopsy proven chronic myocarditis underwent analysis of AMAAB, right and left heart catheterization and left ventriculography at baseline and after six months. Left ventricular volumes and ejection fraction as well as the time constant of left ventricular relaxation "tau" and the constant of myocardial stiffness "b" were determined at baseline and at follow-up. Results In 17 (52%) patients, AMAAB could be detected at baseline. After six months, AMAAB were still found in 13 (76%) initially antibody-positive patients. No initially antibody-negative (n = 16) patient developed AMAAB during follow-up. Clinical symptoms improved slightly in antibody-negative patients and remained stable in antibody-positive patients. Left ventricular ejection fraction developed significantly better in antibody-negative patients (+8.9 +/- 10.1%) compared with antibody-positive patients (-0.1 +/- 9.4%) (p < 0.012). Stroke volume (SV) and stroke volume index (SVI) also improved in antibody-negative patients (SV: +20 +/- 31 ml; SVI: +10 +/- 17 ml) compared with antibody-positive patients (SV: -14 +/- 43 ml; SVI: -8 +/- 22 ml) (SV: p < 0.015; SVI: p < 0.016). Left ventricular end-diastolic and end-systolic volumes and the time constant of left ventricular relaxation "tau" did not change significantly different in antibody-positive and antibody-negative patients. The constant of myocardial stiffness "b" improved significantly in antibody-negative patients (-6.1 +/- 10.8) compared with antibody-positive patients (+7.3 +/- 22.6) (p < 0.040). Analyzing only the persistently antibody-positive patients yielded essentially the same results. Conclusions Antimyosin autoantibodies are associated with worse development of left ventricular systolic function and diastolic stiffness in patients with chronic myocarditis.

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Research works printed but not linked: 4

  1. Aretz, 1987, Myocarditis, Am J Cardiovasc Pathol, 1, 3
  2. Kühl, 1992, Dilative Kardiomyopathie-eine chronische Myokarditis? Immunhistologische Charakterisierung lymphozytärer Zellen, Herz, 17, 97
  3. Morimoto, 1992, Clinical and pathologic features of chronic myocarditis, Am J Cardiovasc Pathol, 4, 181
  4. Neu, 1987, Coxsackie virus induced myocarditis in mice, Clin Exp Immunol, 69, 566

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Metadata

Authors
Lauer, B., Schannwell, M., Kühl, U., Strauer, B.-E., & Schultheiss, H.-P.
Affiliations
  • Leipzig University (DE)
  • Heinrich Heine University Düsseldorf (DE)
Corresponding author
Lauer, Bernward
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2000-01
Volume
35
Issue
1
Pages
11-18
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2078336460
Cited by
197
References
55
Citations by year
2026: 1 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 6 · 2021: 3 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 9 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 11 · 2012: 6
FWCI
6.69
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
Keywords
chronic myocarditis, left ventricular function, systolic function, diastolic function, left ventricular ejection fraction, myocardial stiffness, left ventricular relaxation, stroke volume, autoantibody persistence, left ventriculography, cardiac catheterization, left ventricular volume
MeSH terms
Adult, Aged, Autoantibodies, Autoimmune Diseases, Biopsy, Chronic Disease, Diastole, Endocardium, Female, Humans, Male, Middle Aged, Myocardial Contraction, Myocarditis, Myosins, Stroke Volume, Systole, Ventricular Function, Left, Ventricular Dysfunction, Left

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