A POSSIBLE ROLE FOR AUTOANTIBODIES IN LEFT-VENTRICULAR HYPERTROPHY

The purpose of the study waste investigate the possible role of autoan tibodies in the development and type of left-ventricular hypertrophy ( LVH). Three groups of subjects were studied: (a) 15 patients with hype rtrophic cardiomyopathy (HCM; 11 males, 4 females; mean age 50.0 +/- 1 6..3 years); (b) 15 patients with essential hypertension (10 males, 5 females; mean age 56.8 +/- 13.5 years) with normal renal function and serum electrolytes and (c) 15 male athletes (mean age 20.8 +/- 5.9 yea rs). The control group consisted of 15 normal subjects with no sign of heart disease. The following indices of cardiac performance were dete rmined by means of echocardiography: end-diastolic and end-systolic di ameters, interventricular septum thickness, left-ventricular (LV) wall thickness, LV mass and LV mass index. The immunologic parameters stud ied included autoantibodies against (a) specific (anticardiac cell; AC A) and (b) nonspecific (antimitochondrial cell; AMA) autoantigens acco rding to a conventional indirect immunofluorescence technique. (1) Hig her values for LV mass and LV mass index were observed in HCM. (2) The incidence of specific and nonspecific autoantibodies in hypertensive patients and in patients with HCM was significantly higher compared to athletes and controls. All ACA-positive individuals (5 with HCM, 3 wi th hypertension and 1 athlete) were AMA positive as well, while all AC A-negative individuals were also AMA negative. The ACA-positive indivi duals had higher C3c and C4 levels compared to the ACA-negative indivi duals. An autoantibody-mediated immunopathogenic role is discussed in the development and type of myocardial hypertrophy.