Heart Rhythm
Volume 3, Issue 10 , Pages 1182-1186 , October 2006

Inappropriate sinus tachycardia may be related to an immunologic disorder involving cardiac β andrenergic receptors

  • Pablo A. Chiale, MD

      Affiliations

    • Division of Cardiology, Ramos Mejía Hospital, Buenos Aires, Argentina
    • Instituto Sacre Coeur, Buenos Aires, Argentina
    • Corresponding Author InformationAddress reprint requests and correspondence: Pablo A. Chiale, M.D., Centro de Arritmias Cardíacas, de la Ciudad Autónoma de Buenos Aires, Urquiza 609, 1221 Buenos Aires, Argentina.
    • ,
  • Hugo A. Garro, MD

      Affiliations

    • Division of Cardiology, Ramos Mejía Hospital, Buenos Aires, Argentina
    • Instituto Sacre Coeur, Buenos Aires, Argentina
    • ,
  • Jorge Schmidberg, MD

      Affiliations

    • Division of Cardiology, Ramos Mejía Hospital, Buenos Aires, Argentina
    • ,
  • Rubén A. Sánchez, MD

      Affiliations

    • Division of Cardiology, Ramos Mejía Hospital, Buenos Aires, Argentina
    • Instituto Sacre Coeur, Buenos Aires, Argentina
    • ,
  • Rafael S. Acunzo, MD

      Affiliations

    • Division of Cardiology, Ramos Mejía Hospital, Buenos Aires, Argentina
    • Instituto Sacre Coeur, Buenos Aires, Argentina
    • ,
  • Manuel Lago, MD

      Affiliations

    • Division of Cardiology, Ramos Mejía Hospital, Buenos Aires, Argentina
    • ,
  • Gabriela Levy, PhD

      Affiliations

    • Instituto de Ingeniería Genética y Biología Molecular (INGEBI-CONICET), Buenos Aires, Argentina.
    • ,
  • Mariano Levin, PhD

      Affiliations

    • Instituto de Ingeniería Genética y Biología Molecular (INGEBI-CONICET), Buenos Aires, Argentina.

Received 25 April 2006 ,Accepted 8 June 2006.

References 

  1. Morillo CA , Klein GJ , Thakur RK , Li H , Zardini M , Yee R . Mechanism of “inappropriate” sinus tachycardia (Role of sympato-vagal balance) . Circulation . 1994;90:871–877
  2. Krahn AO , Yee R , Klein GJ , Morillo C . Inappropriate sinus tachycardia: evaluation and therapy . J Cardiovasc Electrophysiol . 1995;6:1124–1128
  3. Kalman JM . Inappropriate sinus tachycardia: an update . Cardiac Electrophysiol Rev . 1997;1/2:61–66
  4. Bauerfeind RA , Amat y Leon F , Dhingra RD , Kehoe R , Wyndham C , Rosen KM . Chronic nonparoxysmal sinus tachycardia in otherwise healthy persons . Am Intern Med . 1979;91:702–710
  5. Castellanos A, Moleiro F, Chakko S, Acosta H, Huikuri H, Mitrani RD, et al. Heart rate variability in inappropriate sinus tachycardia . Am J Cardiol . 1998;82:531–534
  6. Shen WK . How to manage patients with inappropriate sinus tachycardia . Heart Rhythm . 2005;2:1015–1019
  7. Magnusson Y , Wallukat G , Waagstein F , Hjalmarson A , Hoebeke J . Autoimmunity in idiopathic dilated cardiomyopathy (Characterization of antibodies against the β1 adrenoceptor with positive chronotropic effect) . Circulation . 1994;89:2760–2767
  8. Rosenbaum MB , Chiale PA , Schejtman D , Levin M , Elizari MV . Antibodies to β adrenergic receptors disclosing agonist-like properties in idiopathic dilated cardiomyopathy and Chagas’ heart disease . J Cardiovasc Electrophysiol . 1994;5:367–375
  9. Chiale PA, Rosenbaum MB, Elizari MV, Hjalmarson A, Magnusson Y, Wallukat G, et al. High prevalence of antibodies against beta 1- and beta 2-adrenoceptors in patients with primary electrical cardiac abnormalities . J Am Coll Cardiol . 1995;26:864–869
  10. Ferrari I , Levin M , Elizari MV , Rosenbaum MB , Chiale PA . Cholinergic autoantibodies in sinus-node dysfunction . Lancet . 1997;26:262–263
  11. Farías de Oliveira S , Pedrosa RC , Nascimento JHM , Campos de Carvalho AC , Masuda MO . Sera from chronic chagasic patients with complex cardiac arrhythmias depress electrogenesis and conduction in isolated rabbit hearts . Circulation . 1997;96:2031–2037
  12. Chiale PA, Ferrari I, Mahler E, Vallazza MA, Elizari MV, Rosenbaum MB, et al. Differential profile and biochemical effects of antiautonomic membrane receptor antibodies in ventricular arrhythmias and sinus dysfunction . Circulation . 2001;103:1765–1771
  13. Baba A, Yosikawa T, Fukuda Y, Sugiyama T, Shimada M, Akaishi M, et al. Autoantibodies against M2-muscarinic acetylcholine receptors: new upstream in atrial fibrillation in patients with dilated cardiomyopathy . Eur Heart J . 2004;25:1108–1115
  14. Elies R, Ferrari I, Wallukat G, Lebesgue D, Chiale P, Elizari MV, et al. Structural and functional analysis of the β cell epitopes recognized by anti-receptor autoantibodies in patients with Chagas’ disease . J Immunol . 1996;157:4203–4211
  15. Frielle T , Collins S , Daniel KW , Caron MG , Lefkowitz RJ , Kobilka BK . Cloning of the cDNA for the human β 1-adrenergic receptor . Proc Natl Acad Sci USA . 1987;84:7920–7924
  16. Gutkind JS , Novotny EA , Brann MR , Robbins KC . Muscarinic acetylcholine receptor subtypes as agonist dependent oncogenes . Proc Natl Acad Sci USA . 1991;88:4703–4707
  17. Jahn R , Boivin V , Siegmund C , Inselmann G , Lohse MJ , Beoge F . Autoantibodies activating human β 1-adrenergic receptors are associated with reduced cardiac function in chronic heart failure . Circulation . 1999;99:649–654
  18. Strosberg AD . Biotechnology of beta-adrenergic receptors . Mol Neurobiol . 1990;4:211–250
  19. Matsui S, Fu MLX, Katsuda S, Hayase M, Yamaguchi N, Teraoka K, et al. Peptides derived from cardiovascular G-protein-coupled receptors induce morphological cardiomyopathic changes in immunized rabbits . J Moll Cell Cardiol . 1997;29:641–655
  20. Kaplan D, Ferrari I, Lopez Bergami PL, Mahler E, Levitus G, Chiale PA, et al. Antibodies to ribosomal P proteins of Trypanosoma cruzi in Chagas disease possess functional autoreactivity with heart tissue and differ from anti-P autoantibodies in lupus . Proc Natl Acad Sci USA . 1997;94:10301–10306
  21. Müller J, Wallukat G, Dandel M, Bieda H, Brandes K, Spiegelsberger S, et al. Immunoglobulin adsorption in patients with idiopathic dilated cardiomyopathy . Circulation . 2000;101:385–391
  22. Felix SB, Staudt A, Dorffel WV, Stangl V, Merkel K, Pohl M, et al. Hemodynamic effects of immunoadsorption and subsequent immunoglobulin substitution in dilated cardiomyopathy: three-month results from a randomized study . J Am Coll Cardiol . 2000;35:1590–1598

 This work was supported in part by the Fundación de Investigaciones Cardiológicas Einthoven and by a grant from the Public Health Secretariat of the Government of the City of Buenos Aires, Argentina. Dr. Mariano Levin was mainly supported by an International Research Grant of the Howard Hughes Medical Institute (Chevy Chase, Maryland) and the National Agency of Scientific and Technological Promotion (FONCYT BID 1201/OC-AR 01-14389).

PII: S1547-5271(06)01614-6

doi: 10.1016/j.hrthm.2006.06.011

Heart Rhythm
Volume 3, Issue 10 , Pages 1182-1186 , October 2006

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