Aptamer Therapy for Heart Failure?

Abstract

See related article, pages 986–992 Autoantibodies (AAbs) to β-adrenergic receptors (β-AR) are common in certain subsets of heart failure, where they have the potential to cause adverse myocardial biological effects.1–7 β1-AR AAbs are especially common in peripartum8 and Chagas9,10 cardiomyopathies, but they are also relatively prevalent (>25%) in dilated cardiomyopathies of both idiopathic and ischemic origins.1,5,11–14 The presence of β1-AR AAbs is also associated with ventricular arrhythmias and an increased prevalence of sudden cardiac death.15 As a functional validation of their putative pathophysiologic role, in animal models anti-β1-AR antibodies have been shown to induce cardiomyopathies.16–18 The prevalence of β1-AR AAbs in heart failure patients is currently being examined prospectively in the Etiology, Titer-Course, and Survival (ETiCS) Study.14 ETiCS is an ongoing prospective investigation of β1-AR–directed autoimmunity in postmyocarditis and postmyocardial infarction dilated cardiomyopathies, and it also includes an associated retrospective analysis in other types of heart failure. This study should establish the prevalence of β …