Predictive value of heart-type fatty acid-binding protein for left ventricular remodelling and clinical outcome of hypertensive patients with mild-to-moderate aortic valve diseases
Predictive value of heart-type fatty acid-binding protein for left ventricular remodelling and clinical outcome of hypertensive patients with mild-to-moderate aortic valve diseases
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DOI：
10.1038/sj.jhh.1002195
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发表时间：
2007-07-01
影响因子：
2.7
通讯作者：
Kamiya, K.
中科院分区：
文献类型：
--
作者：
Iida, M.;Yamazaki, M.;Kamiya, K.
心肌型脂肪酸结合蛋白(H-FABP)是急性心肌梗死的标志物，也是一种可溶性胞浆蛋白，在高血压、主动脉瓣关闭不全(AR)或主动脉狭窄(AS)所致的心脏超负荷心脏重构后可释放。我们的目的是调查H-FABP水平是否与合并AR或AS的高血压患者的左心室重构和临床结果相关。测定78例合并轻中度AR、73例合并轻中度AS和50例无瓣膜病(HT)患者的H-FABP和脑利钠肽(BNP)，用改良的肾脏疾病饮食(MDRD)方程估算肾小球滤过率(GFR)，并用超声心动图测定经校正的体表面积(LVDS/BSA)和相对室壁厚度(RWT)后的左心室收缩末期内径(LVDS/BSA)。AR组(4.9+/-3 ng/ml)和AS组(4.5+/-3)显著高于HT组(3.4+/-1)和BNP组(65+/-73pg/ml，76+/-75，35+/-22)。校正年龄、性别等因素后，AR组H-FABP与LVDS/BSA相关(β=0.23，P<0.05)，AS组RWT与H-FABP相关(β=0.18，P&t；0.05)。对AS和AR患者进行了34719个月的前瞻性心脏事件随访。多因素Cox风险分析显示，H-FABP是AR(相对危险度RR=7.61，95%CI=2.39-25.3)和AS(RR=13.6，95%CI=3.27-66.9)预后的独立预测因子。H-FABP与左心室重构相关，可用于预测合并轻中度主动脉瓣病变的高血压患者的临床结果。
Heart-type fatty acid-binding protein (H-FABP), a marker of acute myocardial infarction and a soluble cytosolic protein, may be released following left ventricular remodelling in cardiac overloaded hearts caused by hypertension, aortic regurgitation (AR) or aortic stenosis (AS). Our aim was to investigate if H-FABP levels are associated with left ventricular remodelling and clinical outcome in hypertensive patients with AR or AS. H-FABP and brain natriuretic peptide (BNP) were measured, glomerular filtration rate (GFR) was estimated using the modification of diet in renal disease (MDRD) equation, and left ventricular dimension at systole corrected for body surface area (LVDs/ BSA) and relative wall thickness (RWT) were determined by echocardiography in hypertensive patients with mild-to-moderate AR (n = 78), those with mild-to-moderate AS (n = 73) and those without valvular heart diseases (HT) ( n = 50). H-FABP levels were significantly higher in AR (4.9 +/- 3 ng/ml) and in AS (4.5 +/- 3) than in HT (3.4 +/- 1) and BNP (65 +/- 73 pg/ ml, 76 +/- 75, 35 +/- 22). H-FABP correlated with LVDs/BSA in AR (beta = 0.23, P < 0.05), and RWT in AS (beta = 0.18, P < 0.05) after adjustment for age, gender and all the other variables. AS and AR patients were prospectively followed up for cardiac events during 34719 months. A multivariate Cox hazard analysis indicated H-FABP was an independent predictor of outcome both in AR ( relative risk (RR) = 7.61, 95% CI = 2.39 - 25.3) and AS (RR = 13.6, 95% CI = 3.27 - 66.9). H-FABP, associated with left ventricular remodelling, is useful in predicting clinical outcome in hypertensive patients with mild-to-moderate aortic valve diseases.