Document Detail

Autoantibodies produced against sarcolemmal Na-K-ATPase: possible upstream targets of arrhythmias and sudden death in patients with dilated cardiomyopathy.
MedLine Citation:
PMID:  12354443     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to test the hypothesis that autoantibodies (Abs) produced against sarcolemmal Na-K-ATPase play a role in the development of ventricular tachycardia (VT) and cardiac sudden death in patients with dilated cardiomyopathy (DCM). BACKGROUND: Autoimmunity is one of the mechanisms of pathogenesis of DCM as well as virus infection and genetic predisposition. METHODS: One hundred patients with DCM and age-matched control subjects (CTL) were screened for Abs produced against Na-K-ATPase by using enzyme-linked immunosorbent assay. RESULTS: Abs were detected in 26 DCM and 2 CTL patients. Na-K-ATPase activity in the presence of patient IgG was lower in DCM with Abs than without Abs, but there was no difference between two groups in CTL. Western blots showed that Abs recognized the alpha subunit of Na-K-ATPase, and 3H-ouabain bindings in the presence of patient IgG showed that dissociation constant was higher in DCM with Abs than without Abs. No difference existed between subjects with regard to age, gender, New York Heart Association functional class, cardiac function, or neurohormone levels, except for plasma norepinephrine, which was higher in patients with Abs than without Abs. VTs were more common in patients with Abs than without Abs, and multiple logistic regression analysis demonstrated that the presence of Abs, but not plasma norepinephrine, was an independent predictor for the occurrence of VT. Cardiac sudden death was independently predicted by the presence of Abs, as well as poor systolic function. CONCLUSION: We conclude that there are Abs produced against sarcolemmal Na-K-ATPase in patients with DCM and that Abs could be responsible for the electrical instability in some cases.
Akiyasu Baba; Tsutomu Yoshikawa; Satoshi Ogawa
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  40     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-30     Completed Date:  2002-10-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1153-9     Citation Subset:  AIM; IM    
Department of Medicine, Kitasato Institute Hospital, Tokyo, Japan.
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MeSH Terms
Autoantibodies / blood*
Cardiomyopathy, Dilated / blood*,  complications*
Death, Sudden, Cardiac / etiology*
Enzyme-Linked Immunosorbent Assay
Follow-Up Studies
Middle Aged
Risk Factors
Sarcolemma / enzymology*
Sodium-Potassium-Exchanging ATPase / blood*
Tachycardia, Ventricular / blood*,  etiology*
Time Factors
Reg. No./Substance:
0/Autoantibodies; EC ATPase

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