Prognostic Value of beta 1 Adrenergic Receptor Autoantibody and Soluble Suppression of Tumorigenicity-2 in Patients With Acutely Decompensated Heart Failure

Background: Both beta 1 adrenergic receptor autoantibody (beta 1-AA) and soluble suppression of tumorigenicity-2 (sST2) take a role in the pathological remodeling of heart failure. However, limited studies investigated the correlation between the expression of beta 1-AA and sST2 in patients with acutely decompensated heart failure (ADHF).Objective: To explore the correlation between beta 1-AA and sST2, and evaluate their prognostic value in patients with ADHF.Methods: Patients who were admitted for ADHF were included. The N-terminal pro-brain natriuretic peptide (NT-proBNP), sST2, and beta 1-AA in blood samples were tested at hospital admission and then followed up for assessing the outcomes. Pearson correlation analysis was used to explore the correlation between beta 1-AA and sST2. The effects of beta 1-AA, sST2, or the combination of them on the all-cause mortality of patients with ADHF were assessed by Multivariate Cox regression analysis.Results: There were 96 patients with ADHF and 96 control populations enrolled. The beta 1-AA was significantly higher in ADHF than in the control group (0.321 & PLUSMN; 0.06 vs. 0.229 & PLUSMN; 0.04, P = 0.000). Pearson correlation analysis showed that beta 1-AA was positively correlated with sST2 (r = 0.593), NT-proBNP (r = 0.557), Procalcitonin (r = 0.176), and left ventricular end-diastolic diameter (r = 0.315), but negatively correlated with triglycerides (r = -0.323), and left ventricular ejection fraction (r = -0.430) (all P < 0.05) in ADHF. Patients with ADHF, complicated with both high beta 1-AA and sST2, showed the highest all-cause mortality during an average of 25.5 months of follow-up. Multivariate Cox regression showed the combination of both high beta 1-AA and sST2 independently correlated with the all-cause mortality after adjustment for other risk factors (hazard ratio 3.348, 95% CI 1.440 to 7.784, P = 0.005). After adding with beta 1-AA and sST2, the area under the curves for the prognostic all-cause mortality could increase from 0.642 to 0.748 (P = 0.011).Conclusion: The beta 1-AA is positively correlated with sST2 in patients with ADHF. Elevated plasma beta 1-AA and sST2 level in patients with ADHF are associated with poorer prognoses.