Author + information
- Lin Zhang,
- Xin Wang,
- Zhiyong Zhang,
- Lin Xu,
- Jiamei Liu,
- Juan Zhang,
- Hua Wang,
- Jin Chen,
- Hakon Hakonarson,
- Aihua Hu and
- Qian Du
Previously, we reported that autoantibodies specific for the angiotensin II type I receptor (anti-AT1-AR) is implicated in the pathology of congestive heart failure (CHF). We hypothesized that the presence of anti- AT1-AR is associated with left ventricular (LV) function of CHF patients in response to perindopril, which is a long-acting angiotensin-converting-enzyme inhibitor.
Synthetic angiotensin AT1 receptor (AT1-AR) peptides served as the target antigen in ELISA was used to screen the sera of 156 CHF patients, then patients were divided into positive (+) anti- AT1-AR or negative (−) anti- AT1-AR groups based on their anti- AT1-AR reactivity. Echocardiography and 6-minute walk distance were performed at baseline and after one year of perindopril therapy in combination with metoprolol, diuretics and digoxin in both group.
A total of 138 patients completed the final analysis in this study, including 82 patients with (+) anti- AT1-AR and 56 patients with (−) anti- AT1-AR. Compared to the patients with (−) anti- AT1-AR, patients with (+) anti- AT1-AR had a greater improvement in LV end-diastolic and end-systolic dimensions (all p<0.001), as well as 6-minute walk distance (p<0.001) after one year of perindopril therapy in combination with metoprolol, diuretics and digoxin treatment. Interestingly, the presence of (+) anti- AT1-AR resulted in a greater improvement in LV remodeling and function compared to (−) anti- AT1-AR (p<0.001). The combined endpoint event was significant lower in patients with (+) anti- AT1-AR than that in patients with (−) anti- AT1-AR (p<0.05, 36.5% vs. 69.9%).
In patients with (+) anti- AT1-AR, compared with (−) anti- AT1-AR patients, same dose of the perindopril, has a better clinical therapeutic effect on congestive heart function so as to decrease the combined endpoint events. This result potentially presents a novel biomarker of the renin-angiotensin-aldosterone system for the detection as well as therapeutic intervention of congestive heart failure patients.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: New Paradigms in Prognostic Role of Biomarkers in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1265-303
- 2013 American College of Cardiology Foundation