Autoimmune markers are undetectable in end stage idiopathic dilated cardiomyopathy.

Background- Autoreactive humoral and cellular immune responses amy be involved in the pathogenesis of idiopahtic dilated cardiomyopahty (IDC). Certain human leucofcyte antigens (HLA) could als be linked to the development of IDC. Aim. Tot determine whether various markers of autoimmunity are present in the final pahe of the disease, to substantiate the role of an autoimmune process in IDC. Methods 37 patients with end stage IDC were studied, together with 39 patients with end stage heart diease of kanown aetiology who were included for comparison. Multiple myocardial tissue samples from the explanted heart of eacht patient were evaluated (immuno)histologically. An indirect immunofluorescence assay was used to screen patient serum samples for the preseence of heart specific autoantibodies. HLA class I and II frequencies were determinde in each group and compared with HLA frequenceis form healthy blood donors. Results. Only scanty small mononuclear cell infiltrates were present in myocardial tissue of seven patients with IDC and of 11 patients with heart disease of know cause. The majority of these inflammatory cells were negative for T-cell markers. All blodd specimens were negative for heart specific autoantibodies and there was no apparent association of IDC with particular HLA phenotypes. Conclusions. These findings suggest that an active autoimmunce process is not involved in the end stage if IDC