Clinical significance of expression of anti-β1-adrenergic receptor autoantibody in hypertension with left ventricular diastolic dysfunction
Objective:To investigate the expression and clinical significance of anti-β1-adrenergic receptor autoantibody (β1-AR-Ab) in patients with hypertension complicated with left ventricular diastolic dysfunction.Methods:Patients with essential hypertension and healthy volunteers were selected as the research subjects from April 2018 to December 2018. Echocardiography was performed after admission. Forty-nine patients with essential hypertension complicated with left ventricular diastolic dysfunction and left atrial enlargement were selected as a research group and 95 healthy persons were included as a control group. The left ventricular ejection fraction (LVEF), left ventricular posterior wall thickness (LVPW), ventricular septal thickness (IVS), left ventricular end diastolic diameter (LVEDd), left atrial end diastolic diameter (LAEDd), E/A and E/e' ratios, and serum β1-AR-Ab (OD value) were compared between the two groups. The incidence of serum β1-AR-Ab positivity (OD value > 2.1) and the OD value of serum β1-AR-Ab were compared between the two groups. The correlation of serum β1-AR-Ab level with age, gender, blood pressure, heart rate, and echocardioimagedata indexes was analyzed by logistic multiple regression analysis. The predictive value of serum β1-AR-Ab level in hypertension with left ventricular diastolic dysfunction was evaluated by receiver operating characteristic (ROC) curve analysis.Results:The positive rate of serum β1-AR-Ab in the study group was significantly higher than that of the control group (P<0.05). Serum β1-AR-Ab level was significantly higher in the study group than in the control group (P<0.001), and in patients with severe left ventricular diastolic dysfunction than in patients with mild and moderate left ventricular diastolic dysfunction as well as healthy volunteers (P<0.001). Logistic multiple regression analysis showed that there was no significant correlation between serum β1-AR-Ab level and age, gender, and blood pressure. Taking E/A and E/e' ratios as the gold standard, the predictive value of serum β1-AR-Ab level for left ventricular diastolic dysfunction in patients with hypertension was analyzed: sensitivity 69.4%, specificity 81.1%, and area under the ROC curve = 0.788, which were statistically better compared with those of Az=0.5 (P<0.001).Conclusion:Serum β1-AR-Ab significantly increases in hypertensive patients with left ventricular diastolic dysfunction, and it has high sensitivity and specificity in predicting hypertension with left ventricular diastolic dysfunction.
万方数据
