Relationship between Autoantibody to the Angiotensin II-1 Receptor and Cardiovascular Manifestations of Graves’ Disease

J. Xu; L. Zhao; G. Xiang; C. Xu

doi:10.1055/s-0034-1370920

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2014; 122(04): 254-258
DOI: 10.1055/s-0034-1370920

Article

Relationship between Autoantibody to the Angiotensin II-1 Receptor and Cardiovascular Manifestations of Graves’ Disease

J. Xu

¹Wuhan Clinical Medicine College, Southern Medical University, Wuhan, China

²Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China

,

L. Zhao

²Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China

,

G. Xiang

²Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China

,

C. Xu

²Department of Endocrinology and metabolism, Wuhan General Hospital of Guangzhou Command, Wuhan, China

› Author Affiliations

Abstract

Objective:

To investigate the role of autoantibody against angiotensin II-1 receptor (AT₁-AA) in patients with cardiovascular manifestations of Graves’ disease (GD).

Methods:

The epitope of the second extracellular loop of AT₁ receptor (165–191) was synthesized and used as antigens to screen the autoantibody by enzyme linked immunosorbent assay (ELISA). The patients with GD were divided into the patients with cardiovascular manifestations associated to GD (Group A, n=58) and the patients with GD not complicated by heart disease (Group B, n=60). 40 healthy subjects were included in the study (Group C, n=40). Echocardiography was performed and the differences of echocardiography parameters were compared between AT₁-AA positive and negative groups in group A. Factors related to left heart enlargement were analyzed by multiple logistic regression.

Results:

(1) The frequency of AT₁-AA in Group A (52.2%, 32/58) were significantly higher than those in Group B (16.7%, 10/60) and Group C (12.5%, 5/40) (all p<0.001). (2) There were no differences in the level of TGAb, TPOAb and TRAb between AT₁-AA positive and negative groups in patients with GD (all p>0.05). (3) In patients with cardiovascular manifestations of GD, the ratios between left atrial and ventricular enlargement (LAE and LVE) were significantly higher in the AT₁-AA positive group than in the AT₁-AA negative group (68.8% vs. 26.9%, 62.5% vs. 23.1%, all p<0.01); the frequency of atrial fibrillation differed significantly between these 2 groups (53.1% vs. 19.2%, p<0.01). (4) Regression analysis demonstrated that the positive AT₁-AA and course of GD were significantly correlated to the presence of LAE and LVE.

Conclusions:

AT₁-AA plays an important role in the pathogenesis of cardiovascular manifestations associated to GD. Especially, AT₁-AA is involved in left cardiac dilatation of GD complicated by heart disease, which represents a cardiovascular risk factor for GD patients.

Key words

angiotensin II-1 - receptor - autoantibody - cardiovascular manifestations - Graves’ disease

Full Text

References

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