Persistently increased serum concentration of heart-type fatty acid-binding protein predicts adverse clinical outcomes in patients with chronic heart failure
Persistently increased serum concentration of heart-type fatty acid-binding protein predicts adverse clinical outcomes in patients with chronic heart failure
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DOI：
10.1253/circj.72.109
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发表时间：
2008-01-01
影响因子：
3.3
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Niizeki, Takeshi;Takeishi, Yasuchika;Kubota, Isao
背景心肌型脂肪酸结合蛋白(H-FABP)是一种在心肌损伤时释放到循环中的小分子胞浆蛋白。方法和结果连续113例慢性心力衰竭(CHF)患者在入院和出院时测定了血清H-FABP水平。确定了以下三种变化模式。在41例患者中，入院和出院时H-FABP水平(<；4.3 ng/ml)均正常(组1)。其余72例患者入院时H-FABP水平较高(>；=4.3 ng/ml)，其中21例(29%)出院时H-FABP降至正常范围(第2组)，而51例CHF患者尽管症状和体征改善，H-FABP仍持续升高(第3组)。随访期内发生心脏事件33例(29%)，第3组心脏事件发生率显著高于第1组和第2组(p=0.0002)。结论动态监测H-FABP水平是一种新的监测手段，可为CHF患者的最佳治疗和管理提供信息。
Background Heart-type fatty acid-binding protein (H-FABP) is a small cytosolic protein that is released into the circulation when the myocardium is injured. This study examined whether serial measurement of the H-FABP level provides additional prognostic information.Methods and Results Serum H-FABP levels were measured in 113 consecutive chronic heart failure (CHF) patients at both admission and discharge. The following 3 patterns of changes were identified. In 41 patients, H-FABP levels (< 4.3 ng/ml) at both admission and discharge were normal (Group 1). The remaining 72 patients had high initial H-FABP levels (>= 4.3 ng/ml) at admission, and in 21 of them (29%), H-FABP decreased to the normal range at discharge (Group 2), whereas 51 had persistently high H-FABP levels despite improvement in symptoms and signs of CHF (Group 3). There were 33 cardiac events (29%) during the follow-up period, and Group 3 had significantly higher cardiac event rates than Groups 1 and 2 (p=0.0002). Group 3 had the highest cardiac risk among the groups (hazard ratio 5.68, p=0.012).Conclusion Serial measurement of the H-FABP level is a new monitoring tool that provides information to guide optimal therapy and management of CHF patients.