To determine whether autoantibodies against beta(1)-adrenergic and M(2)-muscarinic receptors are related to patients with congestive heart failure (CHF). Both synthetic peptides corresponding to amino acids sequence 197-222 and 169-173 of the second extracellular loops of the beta(1) and M(2) receptors were used as antigens to screen sera from 265 patients.188 were congestive heart failure ( CHF) patients with different heart diseases, among them 42 were ischemic cardiomyopathy (ICD) and 52 were idiopathic dilated cardiomyopathy (IDCM) 44 were hypertensive heart disease (HHD) 50 were rheumatic valvular heart disease (RVHD); 77 were controls, among them 36 were simple hypertension and 41 were healthy donors (NC). Positive sera for beta(1)-adrenergic receptor was found in 45.73% (86/188) of CHF patients, while in the controls it was 10.4% (8/77) (P < 0.01); positive sera for M(2)-muscarinic receptor in CHF patients was found in 49.5% (99/188), while in the control it was 11.7% (9/77) (P < 0.01). The positive ratio of autoantibodies against beta(1)-adrenergic and M(2)-muscarinic receptors in CHF patients with cardiac function class II-III (NYHA) were significantly higher than cardiac function class IV. The average titer of autoantibodies against beta(1)-adrenergic and M(2)-muscarinic receptors of the former was significantly higher than the latter; 56.1% of patients with autoantibodies against beta(1)-adrenergic receptor had autoantibodies against M(2)-muscarinic receptor. Autoantibodies against beta(1)-adrenergic receptor and M(2)-muscarinic receptor were found in sera from heart failure patients with different cardiac diseases. We propose that autoantibodies against beta(1) and M(2) receptors are not only related to the IDCM, but also to cardiac structural and functional changes.