{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:42:30Z","timestamp":1793090550823,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The clinical significance of \u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAb (\u03b2\n                      <jats:sub>1<\/jats:sub>\n                      \u2010adrenergic receptor autoantibody) subclasses, particularly IgG3 (immunoglobulin G subclass 3), in contemporary populations with HF (heart failure) remain unclear, especially in relation to \u03b2\u2010blocker therapy and HF phenotype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In this single\u2010center prospective cohort study, we enrolled 408 consecutive patients hospitalized for acute decompensated HF. \u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAbs and IgG subclasses were measured using enzyme\u2010linked immunosorbent assay. Patients were classified into IgG3\u2010positive, non\u2010IgG3\u2010positive, and negative groups. The primary end point was all\u2010cause mortality within 2\u2009years, and the secondary end point was a composite of all\u2010cause death and HF rehospitalization. Multivariable Cox hazards models were used to assess associations, adjusting for clinical covariates, with subgroup analyses by HF phenotype (HF with reduced ejection fraction versus HF with preserved ejection fraction) and \u03b2\u2010blocker use at discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      \u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAbs were detected in 34% of patients, with similar prevalence across HF phenotypes. IgG3\u2010\u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAb positivity was associated with higher in\u2010hospital mortality (11%) and increased risk of all\u2010cause death (adjusted hazard ratio [HR], 2.13 [95% CI, 1.14\u20133.99],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.018) and the composite end point (HR, 1.94 [95% CI, 1.19\u20133.14],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.008). These associations were observed primarily in patients not receiving \u03b2\u2010blockers at discharge, with significant interaction between IgG3\u2010\u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAb and \u03b2\u2010blocker use. Exploratory analyses suggested that these associations were more apparent in HF with preserved ejection fraction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      IgG3\u2010\u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAb positivity was associated with adverse outcomes in acute HF, particularly among patients not treated with \u03b2\u2010blockers. These findings suggest a potential role of IgG3\u2010\u03b2\n                      <jats:sub>1<\/jats:sub>\n                      AR\u2010AAb as a treatment\u2010responsive biomarker, although prospective studies are needed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047402","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:15:18Z","timestamp":1781525718000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Subclass\u2010Specific Impact of \u03b2\n                    <sub>1<\/sub>\n                    \u2010Adrenergic Receptor Autoantibodies and Phenotype\u2010Specific Interaction With \u03b2\u2010Blockers in a Contemporary Population With Heart Failure"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5218-7631","authenticated-orcid":false,"given":"Akane","family":"Kawai","sequence":"first","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3430-4614","authenticated-orcid":false,"given":"Yuji","family":"Nagatomo","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Iwashita","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nao","family":"Morita","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]},{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8304-8651","authenticated-orcid":false,"given":"Ayami","family":"Naito","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Taruoka","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asako","family":"Takefuji","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8704-517X","authenticated-orcid":false,"given":"Risako","family":"Yasuda","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-631X","authenticated-orcid":false,"given":"Takao","family":"Konishi","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinori","family":"Ikegami","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4681-2798","authenticated-orcid":false,"given":"Takumi","family":"Toya","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4426-3692","authenticated-orcid":false,"given":"Nobuyuki","family":"Masaki","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3036-9971","authenticated-orcid":false,"given":"Yasuo","family":"Ido","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyasu","family":"Baba","sequence":"additional","affiliation":[{"name":"Tokai University School of Medicine","place":["Isehara, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Sakakibara Heart Institute","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8335-735X","authenticated-orcid":false,"given":"W. H. Wilson","family":"Tang","sequence":"additional","affiliation":[{"name":"Heart Vascular and Thoracic Institute, Cleveland Clinic","place":["Cleveland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9830-6627","authenticated-orcid":false,"given":"Takeshi","family":"Adachi","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Tokorozawa, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac013"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1594"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.08.074"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-2828(08)80036-3"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1006\/jaut.1999.0310"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/02724570050031176"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(01)01113-X"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0014-2999(03)01431-6"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI20149"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.09.057"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1006\/jmcc.2001.1414"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eun138"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)01109-8"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.11.002"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-09-0748"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2008.10.027"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.12.005"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2016.03.005"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.067"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2115"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-25-0002"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20268"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI114888"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2006.01705.x"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0052911"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2014.00520"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-020-00829-6"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.11.051"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001063"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad195"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2024.102376"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2023.5500"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.29524"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:46:19Z","timestamp":1789551979000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,6,16]]}},"alternative-id":["10.1161\/JAHA.125.047402"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047402","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"assertion":[{"value":"2025-10-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e047402"}}