Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure.
Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure.
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DOI：
10.1016/j.clinbiochem.2017.02.014
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发表时间：
2017-06
影响因子：
2.8
通讯作者：
Tang WHW
中科院分区：
文献类型：
--
作者：
Kitai T;Kim YH;Kiefer K;Morales R;Borowski AG;Grodin JL;Tang WHW
静脉充血已越来越被认为是心力衰竭终末器官功能障碍的潜在因素。在腹型高血压和肠缺血患者中发现了升高的I-FABP，其特异性地从受损的肠上皮细胞分泌。我们假设肠脂肪酸结合蛋白（I-FABP）水平升高可以识别出有静脉和肠充血的更晚期心力衰竭患者。对69例急性失代偿性心力衰竭（ADHF）患者的基线血清I-FABP水平进行了测定，这些患者入住重症监护室进行有创血流动力学监测和定制的药物治疗。对所有研究患者进行全面的超声心动图检查，并评估临床结局（死亡、心脏移植或左心室辅助装置放置）。中位循环I-FABP水平为853 pg/ml（四分位数范围：533 - 1448 pg/ml）。低和高I-FABP水平患者的年龄、性别、种族和基线合并症相似。尽管I-FABP水平与有创血流动力学参数和超声心动图参数之间无显著相关性，但与I-FABP水平较低的患者（<853 pg/ml，P=0.025）相比，I-FABP水平较高（≥ 853 pg/ml）的患者临床结局显著较差。循环I-FABP水平与有创测量的血流动力学参数无关，但与伴有收缩功能障碍的ADHF患者的不良临床结局相关。
Venous congestion has become increasingly recognized as a potential contributor to end-organ dysfunction in heart failure. Elevated I-FABP, which is excreted specifically from damaged intestinal epithelial cells, has been found in patients with abdominal hypertension and intestinal ischemia. We hypothesize that elevated intestinal fatty acid-binding protein (I-FABP) levels would identify patients with more advanced heart failure who have venous and intestinal congestion. Baseline serum I-FABP levels were measured in 69 acute decompensated heart failure (ADHF) patients admitted to the intensive care unit for invasive hemodynamic monitoring and tailored medical therapy. Comprehensive echocardiography examinations were performed in all study patients, and clinical outcomes (death, cardiac transplant or left ventricular assist device placement) were assessed. The median circulating I-FABP level was 853 pg/ml (interquartile range: 533 to 1448 pg/ml). Age, gender, race, and baseline comorbidities were comparable between patients with low and high I-FABP levels. Although there were no significant correlations between I-FABP levels and invasively-measured hemodynamic parameters nor echocardiographic parameters, patients with higher I-FABP levels (≥853 g/ml) had significantly worse clinical outcomes compared to those with lower I-FABP levels (<853 pg/ml, P=0.025). Circulating I-FABP levels had no association with invasively-measured hemodynamic parameters, but were associated with adverse clinical outcomes in patients with ADHF with systolic dysfunction.