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Elevated M2-muscarinic and β1-adrenergic receptor autoantibody levels are associated with paroxysmal atrial fibrillation

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Abstract

Background

Pathophysiologic mechanisms underlying lone atrial fibrillation (AF) have not been clearly demonstrated yet. Emerging evidence has indicated that autoimmunity may play a role in the development of AF. Relationship between serum anti-M2-muscarinic receptor autoantibody (anti-M2-R) and anti-β1-adrenergic receptor autoantibody (anti-β1-R) levels and lone paroxysmal atrial fibrillation (PAF) has not been investigated. We aimed to compare anti-M2-R and anti-β1-R levels between lone PAF patients and healthy control subjects.

Methods and results

75 patients with lone PAF (age: 52.80 ± 6.80 years, 53 % male) and 75 healthy control subjects (age: 53.30 ± 6.80 years, 54 % male) were enrolled in the study. Serum anti-M2-R and anti-β1-R levels were measured by ELISA and compared between two groups. Anti-M2-R [142.30 (77.65–400.00) vs. 69.00 (39.48–299.04) ng/mL; p < 0.001) and anti-β1-R [102.56 (65.18–348.41) vs. 44.17 (30.89–158.54) ng/mL; p < 0.001] levels were significantly higher in patients with lone PAF compared to healthy controls. Multivariate regression analysis showed that left atrial diameter (OR: 1.471, p < 0.001), hs-CRP(OR: 1.940, p < 0.001), anti-M2-R (OR: 1.158, p < 0.001) and anti-β1-R (OR: 1.296, p < 0.001) levels were independent predictors for the presence of lone PAF. Using a cut-off level of 101.83 ng/mL, anti-M2-R levels predicted presence of lone PAF with a sensitivity of 94.68 % and specificity of 81.33 %. Anti-β1-R levels predicted presence of lone PAF with a sensitivity of 92.00 % and specificity of 73.30 %, using a cut-off level of 72.16 ng/mL.

Conclusion

Our results demonstrated that higher serum anti-M2-R and anti-β1-R levels are associated with lone PAF. Autoantibodies related to autonomic system may play an important role in the development of lone AF.

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Acknowledgments

Hacettepe University Scientific Research Projects Coordination Unit (845).

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Cardiology, Hacettepe University Faculty of Medicine, 06100, Ankara, Turkey

    Muhammed U. Yalcin, Kadri M. Gurses, Duygu Kocyigit, Banu Evranos, Hikmet Yorgun, Mehmet L. Sahiner, Ergun B. Kaya, Mehmet A. Oto, Necla Ozer & Kudret Aytemir

  2. Department of Basic Oncology, Hacettepe University Cancer Institute, 06100, Ankara, Turkey

    Sacit Altug Kesikli & Dicle Guc

  3. Department of Cardiology, Samsun Training and Research Hospital, 55100, Samsun, Turkey

    Ahmet Hakan Ates

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  1. Muhammed U. Yalcin
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Correspondence to Kadri M. Gurses.

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Yalcin, M.U., Gurses, K.M., Kocyigit, D. et al. Elevated M2-muscarinic and β1-adrenergic receptor autoantibody levels are associated with paroxysmal atrial fibrillation. Clin Res Cardiol 104, 226–233 (2015). https://doi.org/10.1007/s00392-014-0776-1

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