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May 1977

Importance of Myocardial Antibodies in Heart Disease

Arch Intern Med. 1977;137(5):570-572. doi:10.1001/archinte.1977.03630170008004

Clinicians have long recognized the importance of immune mechanisms in certain cardiovascular syndromes. Myocardial autoantibodies (HAb) occur in a number of cardiac states as a result of myocardial injury due to infection, infarction, surgery, or trauma to the heart or pericardium. Cavelti's demonstration of cross-reactivity of the rat heart and Streptococcus antigen in acute rheumatic fever went unheralded for a decade before HAb were implicated in the pathogenesis of this disease.1 Kaplan and Meyeserian's work confirmed that HAb occurred after streptococcal infection in response to a cross-reactive antigen of group A Streptococcus to myofibrils.2 The importance of HAb in the progression of rheumatic heart disease was studied by Ehrenfeld et al by using tanned RBC hemagglutinins in a variety of cardiac and noncardiac diseases.3 His studies indicated HAb was not a cause but a consequence of tissue destruction. High titers of HAb did not lead to histologic

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