Serum Organ-Specific Anti-Heart and Anti-Intercalated Disk Autoantibodies as New Autoimmune Markers of Cardiac Involvement in Systemic Sclerosis: Frequency, Clinical and Prognostic Correlates

Autor:	Corrado Campochiaro, Alida L.P. Caforio, Nicoletta Gallo, Renzo Marcolongo, Mara Seguso, Lorenzo Dagna, Marco Matucci-Cerinic, A Pepe, Sabino Iliceto, Alberto Moggi-Pignone, Mario Plebani, Cosimo Bruni, Lorenzo Tofani, Antonio Esposito, Giovanni Peretto, L Gargani, Elena Pontara, E. Bison, Anna Baritussio, Giacomo De Luca, Maria Grazia Cattini
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	medicine.medical_specialty Medicine (General) Myocarditis autoantibodies systemic sclerosis medicine.medical_treatment Clinical Biochemistry Chest pain medicine.disease_cause Gastroenterology Article Autoimmunity R5-920 Internal medicine Troponin I medicine skin and connective tissue diseases health care economics and organizations biology business.industry autoimmunity Interstitial lung disease Autoantibody Immunosuppression Autoantibodies Prognosis Systemic sclerosis medicine.disease Troponin biology.protein prognosis medicine.symptom myocarditis business
Zdroj:	Diagnostics; Volume 11; Issue 11; Pages: 2165 Diagnostics, Vol 11, Iss 2165, p 2165 (2021) Diagnostics
ISSN:	2075-4418
DOI:	10.3390/diagnostics11112165
Popis:	Background: Heart involvement (HInv) in systemic sclerosis (SSc) may relate to myocarditis and is associated with poor prognosis. Serum anti-heart (AHA) and anti-intercalated disk autoantibodies (AIDA) are organ and disease-specific markers of isolated autoimmune myocarditis. We assessed frequencies, clinical correlates, and prognostic impacts of AHA and AIDA in SSc. Methods: The study included consecutive SSc patients (n = 116, aged 53 ± 13 years, 83.6% females, median disease duration 7 years) with clinically suspected heart involvement (symptoms, abnormal ECG, abnormal troponin I or natriuretic peptides, and abnormal echocardiography). All SSc patients underwent CMR. Serum AHA and AIDA were measured by indirect immunofluorescence in SSc and in control groups of non-inflammatory cardiac disease (NICD) (n = 160), ischemic heart failure (IHF) (n = 141), and normal blood donors (NBD) (n = 270). AHA and AIDA status in SSc was correlated with baseline clinical, diagnostic features, and outcome. Results: The frequency of AHA was higher in SSc (57/116, 49%, p < 0.00001) than in NICD (2/160, 1%), IHF (2/141, 1%), or NBD (7/270, 2.5%). The frequency of AIDA was higher (65/116, 56%, p < 0.00001) in SSc than in NICD (6/160, 3.75%), IHF (3/141, 2%), or NBD (1/270, 0.37%). AHAs were associated with interstitial lung disease (p = 0.04), history of chest pain (p = 0.026), abnormal troponin (p = 0.006), AIDA (p = 0.000), and current immunosuppression (p = 0.01). AHAs were associated with death (p = 0.02) and overall cardiac events during follow-up (p = 0.017). Conclusions: The high frequencies of AHA and AIDA suggest a high burden of underdiagnosed autoimmune HInv in SSc. In keeping with the negative prognostic impact of HInv in SSc, AHAs were associated with dismal prognosis.
Databáze:	OpenAIRE
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