Risk factors and prognostic value of heart-type fatty acid binding protein in patients with heart failure / 中华检验医学杂志

Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.

Skin Ultrastructure and the Changes of HIF-2α, H-FABP Expression in the Myocardium of Electric Shock Death Rats / 法医学杂志

Objective To observe the skin ultrastructure change of electric shock death rats and to test the expression changes of hypoxia-inducible factor-2α （HIF-2α） and heart type-fatty acid-binding protein （H-FABP） of myocardial cells, in order to provide basis for forensic identification of electric shock death. Methods The electric shock model of rats was established. The 72 rats were randomly divided into control group, electric shock death group and postmortem electric shock group. Each group was divided into three subgroups, immediate （0 min）, 30 min and 60 min after death. The skin changes of rats were observed by HE staining, the changes of skin ultrastructure were observed by scanning electron microscopy, and the expression of HIF-2α and H-FABP in rats myocardium was tested by immunohistochemical staining. Results The skin in the electric shock death group and postmortem electric shock group had no significant difference through the naked eye or by HE staining. Under the scanning electron microscope, a large number of cellular debris, cells with unclear boundaries, withered cracks, circular or elliptical holes scattered on the cell surface and irregular edges were observed. A large number of spherical foreign body particles were observed. Compared with the control group, the expression of HIF-2α in all electric shock death subgroups increased, reaching the peak immediately after death. In the postmortem electric shock group, HIF-2α expression only increased immediately after death, but was lower than that of electric shock death group （P<0.05）. Compared with the control group, the expression of H-FABP in all subgroups of electric shock death group and postmortem electric shock group significantly decreased. The expression of H-FABP in all subgroups of electric shock death group was lower than that of the postmortem electric shock group （P<0.05）. Conclusion Electric shock can increase HIF-2α expression and decrease H-FABP expression in the myocardium, which may be of forensic significance for the determination of electric shock death and identification of antemortem and postmortem electric shock.

Significance of heart-type fatty acid binding protein and brain glycogen phosphorylase isoenzyme type in septic myocardial injury / 中国小儿急救医学

Objective@#To demonstrate the relevance of heart-type fatty acid binding protein(H-FABP) and brain glycogen phosphorylase isoenzyme type(GPBB) with myocardial injury in sepsis.To explore the effect of H-FABP and GPBB on the severity of disease and clinical prognosis.@*Methods@#A total of 40 cases of children with sepsis were selected in this study from January 1, 2017 to October 31, 2017.According to the illness severity, they were divided into sepsis group(n=15), severe sepsis group(n=13) and septic shock group(n=12), 19 cases of children with non-infectious diseases were selected as the control group for the same period.The levels of serum WBC, C-reactive protein, procalcitonin, cTnI, CK, CK-MB, CK-MB isoenzyme quality and NT-proBNP were collected within 24 hours of admission.The APECHEⅡ scores were calculated for each child.The peripheral blood of the patients within 24 hours after admission was used to determine the levels of serum H-FABP and GPBB by ELISA method.The differences of clinical indicators among the groups were analyzed.According to the survival of patients with sepsis, they were divided into 37 cases in the improved group and 3 cases in the death group.All patients with sepsis were divided into left ventricular ejection fraction(LVEF) normal group(n=26) and LVEF decreased group(n=14). According to whether the serum cTnI was elevated, all children with sepsis were divided into cTnI normal group (n=29) and cTnI increased group (n=11). The differences of H-FABP and GPBB levels were compared.According to the presence or absence of LVEF decline, the area under the ROC curve was used to evaluate the predictive power of each index for myocardial injury in sepsis.Based on the decrease of LVEF, the area under the ROC curve was used to evaluate the prediction of each index for myocardial injury in sepsis.@*Results@#There were significant differences in H-FABP and GPBB levels among the control group, sepsis group, severe sepsis group and the septic shock group (H=42.241, P<0.05; H=32.486, P<0.05). Although there was no significant difference between the improved group and the death group(P>0.05), there was an elevated trend of H-FABP and GPBB in the death group.The levels of H-FABP (t=-3.770, P=0.001) and GPBB (Z=-2.113, P=0.033) were statistically significant in the LVEF normal group and the LVEF decreased group (LVEF≤60%). There were no significant differences in the levels of H-FABP and GPBB between the cTnI normal group and the cTnI increased group (P>0.05), but the cTnI increased group had an increasing trend.The area under the ROC curve in the diagnosis of myocardial injury in sepsis were H-FABP 0.821, NT-ProBNP 0.738, GPBB 0.661, CK 0.560, cTnI 0.512, in which the sensitivity(0.833) and specificity(0.786)of H-FABP were both higher.@*Conclusion@#The serum H-FABP and the GPBB levels can be used to monitor for myocardial damage, and it has a correlation with the severity of the disease and the prognosis.H-FABP has a significant advantage over traditional myocardial markers in sensitivity and specificity to determine the myocardial injury of sepsis.

Heart-type fatty acid-binding protein predicts the prognosis of pediatric severe pneumonia complicated by acute respiratory distress syndrome / 中国小儿急救医学

Objective To investigate the prognostic value of heart-type fatty acid-binding protein ( H-FABP) in pediatric patients with severe pneumonia complicated by acute respiratory distress syndrome ( ARDS) . Methods We performed a retrospective study to summarize the medical records of 59 pediatric patients with severe pneumonia complicated by ARDS admitted to the PICU at Shanghai Children′s Hospital between November 2016 and October 2017. According to the ratio of PaO2 to FiO2 ,the 59 cases were divided into mild-moderate ARDS group(n=47)(100 mmHg<PaO2/FiO2≤300 mmHg,1 mmHg=0. 133 kPa) and severe ARDS group(n=12)(PaO2/FiO2≤100 mmHg). The cases were devided into survival group and death group according to survival situation on day 28. Forty-two cases with pneumonia were enrolled as con-trol. The data of patient demographics, clinical characteristics, cardiac function indexes, blood biochemical indicators within 6 hours after admission including H-FABP,N-terminal B-type natriuretic peptide,CK-MB, cardiactroponin-I and lactic acid,complications and survival status were collected and analyzed. The receiver operating characteristic(ROC) curve was used to evaluate the power of variables for 28-day mortality in patients with severe pneumonia complicated by ARDS. Results A total of 59 patients with severe pneumonia were enrolled in our study. The 28-day mortality rate was 20. 3％( 12/59 ) . The serum levels of H-FABP, N-terminal B-type natriuretic peptide,CK-MB and lactic acid were significantly higher in severe ARDS group [8. 8(4. 6,13. 4) ng/ml,904(209,11336)pg/ml,29. 5(19. 2,82. 5) U/L and 4. 6(1. 5,6. 1)mmol/L,re-spectively] than those in mild-moderate ARDS group,as well as control group(all P<0. 001). The serum level of H-FABP was significantly higher in the non-survivor[7. 8(4. 1,39. 7)ng/ml] than that in survivor [4. 7(3. 0,6. 0)ng/ml]with ARDS(P=0. 031). The ROC curve analysis indicated that the area under the ROC curve for H-FABP was 0. 783(95％CI 0. 532-0. 894,P <0. 05),and the optimal cut-off value for H-FABP was 6. 8 ng/ml with a sensitivity of 74. 3％ and a specificity of 87. 0％ for predicting the prognosis in patients with ARDS. Conclusion H-FABP is a sensitive indicator for prognosis in pediatric patients with severe pneumonia complicated by ARDS.

Clinical significance of H-FABP,hs-CRP and Hcy in patients with atrial fibrillation and chronic heart fail-ure / 实用医学杂志

Objective To investigate the level changes and clinical value of serum H-FABP,hs-CRP and Hcy in patients with atrial fibrillation(AF)and chronic heart failure(CHF).Methods 120 patients with AF and CHF were chosen as the observation group,100 patients with sinus rhythm were chosen as the control.The levels of H-FABP,hs-CRP and Hcy of the two groups were compared.H-FABP,hs-CRP and Hcy levels were also compared in the different subgroups divided according to the cardiac function.Risults Compared with the control group,the levels of H-FABP,hs-CRP and Hcy in patients with atrial fibrillation were significantly higher(P<0.05).The lev-els of H-FABP,hs-CRP and Hcy in the observation group were higher than those in the control group in the same cardiac function subgroup(P < 0.05). Conclusion The elevation of the level of H-FABP,hs-CRP and Hcy are closely related to the occurrence and maintenance of atrial fibrillation and the damage of myocardial cells,and it was related with the severity of cardiac function.

Perioperative Changes of Serum Biochemical Markers in Patients with PCI / 现代检验医学杂志

Objective To evaluate the perioperative changes of h-FABP,IMA,IL-2R,IL-6,IL-8,TNF-α and MPO in patients with PCI.Methods The serial serum samples from 34 patients were collected from November of 2011 to February of 2012 in coronary care unit of Peking Union Hospital on separately 2,4,8 and 24 hours after PCI,then IL2R,IL6,IL8,TNF-α,h-FABP,IMA and MPO were measured.Results MPO,h-FABP and CKMB increased dramatically at 2 hours after PCI(Z value were separately-3.621,-5.123 and-2.789 compared with the level at 2 h and 24 h,all P＜ 0.05),and h-FABP within 24 hours fell into the normal range.MPO dropped quickly after 4 hours of surgery and CKMB peaked at 4 hours,then decreased.The concentration of CK and cTnⅠ rose up at 4h (Z value were separately-2.803 and-2.31 compared with the level at 2h and 24 h,all P＜0.05) and declined with a climax at 8h after PCI.The correlation coefficient of CKMB and CK with cTnⅠ were higher than 0.6.Conclusion This study provided an overview of the change of multi-biomarkers following PCI,which gave a valuable information for clinical treatment.

Diagnostic value of combined detection of heart type fatty acid binding protein and brain natriuretic peptide for patients with chronic heart failure / 心血管康复医学杂志

Objective:To study diagnostic value of combined detection of heart type fatty acid binding protein (H-FABP) and brain natriuretic peptide (BNP) for chronic heart failure (CHF) in aged patients.Methods:A total of 178 aged CHF patients hospitalized in our hospital from Jul 2015 to Jun 2016 were selected.According to NYHA cardiac function classification,they were divided into class Ⅱ group (n＝70) and class Ⅲ ～ Ⅳ group (n＝48).An-other 52 aged healthy subjects undergoing physical examination were selected as healthy control group simultaneous-ly.Plasma BNP,H-FABP levels,LAD,LVESd,LVEDd,IVST and LVEF were measured and compared among three groups.Correlation among plasma BNP,H-FABP levels and above cardiac function indexes were analyzed.Results:Compared with healthy control group,there were significant rise in plasma levels of BNP [ (50.65 ± 5.86) ng/L vs.(212.65 ± 17.12) ng/L vs.(1264.73 ± 119.74) ng/L] and H-FABP [ (1.68 ± 0.36) ng/ml vs.(3.34 ± 0.56) ng/ml vs.(9.64 ± 1.27) ng/ml],LAD [ (3.25 ± 0.29) cm vs.(4.98 ± 0.23) cm vs.(5.48 ± 0.51) cm],LVESd [ (28.68 ± 2.7) mm vs.(40.98 ± 4.55) mm vs.(58.63 ± 5.75) mm],LVEDd [ (43.22 ± 4.29) mm vs.(56.63 ± 5.23) mm vs.(61.33 ± 6.07) mm] and IVST [ (8.15 ± 0.68) mm vs.(11.87 ± 1.03) mm vs.(15.93 ± 1.43) mm],and significant reduction in LVEF [ (64.84 ± 6.39)% vs.(49.76 ± 4.76)% vs.(35.76 ± 3.62)%] in NYHA class Ⅱ group and NYHA class Ⅲ ～ Ⅳ group;compared with NYHA class Ⅱ group,there were significant rise in plasma levels of BNP and H-FABP,LAD,LVESd,LVEDd and IVST,and significant reduction in LVEF in NYHA class Ⅲ ～ Ⅳ group,P＝0.001 all.Spearman correlation analysis indicated that plasma BNP,H-FABP levels were significant positively correlated with LAD,LVESd,LVEDd and IVST (r＝0.53～0.71,P＝0.001 all),and significant inversely correlated with LVEF (r＝ -0.54,-0.65,P＝0.001 both);plasma BNP level was signifi-cantly positive correlated with H-FABP level (r＝0.36,P＝0.04).Conclusion:Combined detection of BNP and H-FABP contributes to diagnosing CHF in aged patients and assessing its severity.

Correlation of heart-type fatty acid-binding protein and glycogen phosphorylase enzyme BB in brain with septic myocardial injury / 中国小儿急救医学

The incidence of sepsis is on the rise, and the mortality is also high. Myocardial injury caused by sepsis is one of the important causes of death. However,there is no clear and unified diagnostic criteria to sepsis complicated with myocardial injury. The clinical diagnostic criteria of myocardial injury is mainly based on cardiac ultrasound,myocardial markers and so on. But the measurement of ejection fraction is needed to consider the impact of preload and afterload of left ventricula,also the subjective level of opera-tors. So cardiac markers play an important role in the detection of myocardial injury in sepsis and can reflect the severity of myocardial injury and sepsis,especially in the early diagnosis and prognosis. Heart-type fatty acid binding protein and brain glycogen phosphorylase isoenzyme type exhibit higher sensitivity, specificity and stability compared to other traditional cardiac markers in the clinical diagnosis of myocardial injury, which are worth to be studied and applied in the clinical diagnosis of myocardial injury.

Clinical value of heart-type fatty acid binding protein testing in the diagnosis of early myocardial ischemia injury / 中国综合临床

Objective To explore the clinical value of heart-type fatty acid binding protein testing (H-FABP) in the diagnosis of early myocardial ischemia injury.Methods One hundred and eighty cases diagnosed with myocardial ischemia from January 2016 to December 2016 were selected as the experimental group,then according to the disease time,the subjects were divided into the earlier group(≤3 h),middle group(3~6 h)and later group(≥6 h),each group 60 cases.180 cases with healthy physical examination results were enrolled in the control group.The concentration of serum H-FABP and IMA were detected in order to analyze the clinical value comprehensively.Results Compared with the control group,the concentration of serum H-FABP ((11.54±4.31) μg/L) and IMA ((92.72±5.31)U/ml) in the experimental group increased greatly,the differences were statistically significant(t=2.305,3.001,P<0.05).Among the subgroups in the experimental group,the concentration of IMA was the highest in the early stage and decreased in the middle and later stages,and there were significant difference between the earlier group and later group(t=2.326,P<0.05).The concentration of serum H-FABP and IMA in the experimental group and control group were positively correlated (r=0.9237,P<0.05).Positive detection rate analysis showed that the positive rates of H-FABP and IMA among the subgroups were above 80.00%,and the positive rate of combined detection was obviously improved (P<0.05).The clinical diagnosis was used as the gold standard,the Kappa of the results of H-FABP detection and clinical diagnosis was 0.85 (P<0.05).Conclusion H-FABP has a positive clinical significance in the diagnosis of early myocardial ischemia,as IMA has high positive detection rate,and has high consistency with clinical diagnosis results,it can effectively reduce the misdiagnosis rate and combined detection can reduce the rate of missed diagnosis.

Safflower yellow treats the myocardial injury in patients with severe sepsis / 中成药

AIM To investigate the effects of safflower yellow on myocardial injury in patients with severe sepsis.METHODS Using prospective research methods,ninety-two patients with severe sepsis treated in our hospital from Jan.2013 to Mar.2016 were divided equally into two groups:control group (routine treatment) and observation group (routine treatment + safflower yellow).In addition,6 and 72 hours after the treatment,heart-type fatty acid binding protein (H-FABP),creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of patients were detected,and the changes of left ventricular ejection fraction (LVEF) and sequential organ failure assessment (SOFA) scores were observed;length of ICU stay,cumulative incidence of major adverse cardiac events (MACE) and 28-day survival also were recorded at the same time.RESULTS In admission,there were no differences in the levels of H-FABP,CK,CK-MB and LVEF,SOFA scores between the two groups.After 6 hours treatment,the levels of H-FABP,CK,CK-MB and SOFA score in the observation group were lower than those in the control group;the two groups had higher levels of H-FABP,CK and CK-MB than those before the treatment,SOFA score was lower than that before the treatment;After 72 hours treatment,H-FABP,CK,CK-MB and SOFA score were lower than those after 6 hours treatment;SOFA score in the observation group was lower than that in the control group;there were no differences in H-FABP,CK and CK-MB between the two groups.The observation group had a lower cumulative incidence of MACE than the control group.There was no statistical difference in LVEF and length of ICU stay after the treatment between the two groups.The observation group had a higher 28-day survival than the control group,the difference was statistically significant (76.08％,35/46 vs 54.35％,25/46;x2 =4.529,P =0.033).The level of serum H-FABP in severe sepsis patients was negatively correlated with LVEF (r =-0.270,P =0.009).CONCLUSION Therapeutic effects of safflower yellow on myocardial injury in patients with severe sepsis is superior to routine treatment with the improvement of the prognosis of patients to a certain extent.

Diagnostic value and clinical analysis of combined detection of serum H-FABP, hs-CRP and cTnT in patients with myocardial infarction / 中国生化药物杂志

Objective To evaluate the diagnostic value of serum cardiac fatty acid binding protein (H-FABP), high sensitivity C-reactive protein (hs-CRP) and cardiac troponin T (cTnT) in the diagnosis of myocardial infarction. Methods From August 2015 to July 2016, 50 patients with myocardial infarction were treated as group A, and 48 patients with chest pain caused by other factors were treated as group B, and 53 patients were selected in our hospital physical examination of patients without chest pain as C group. The levels of H-FABP, hs-CRP and cTnT were compared between the three groups. The levels of H-FABP, hs-CRP and cTnT in patients with myocardial infarction at 5 h, 10 h, 24 h and 3 d after admission were compared . Results The positive rate of serum H-FABP, hs-CRP and cTnT in group A was significantly higher than that in group B, group C[(82.00％, 41.00), 68.00％ (34/50), 76.00％ (38/50) VS 8.33％(4/48), 14.58％(7/48),10.42％(5/48) VS 0.00％(0/53),0.00％(0/53),0.00％(0/53)], and the difference was statistically significant (P<0.05). The positive rate of H-FABP and hs-CRP was higher than that of admission at 10 h, 24 h and 3 d at 5 h after admission. The positive rate of cTnT was higher than that at 5 h, 24 h and 3 d at admission (P<0.05). The positive rate of H-FABP was significantly higher than that of the control group (P<0.05). Conclusion Combined detection of serum H-FABP, hs-CRP and cTnT can improve the diagnostic value of myocardial infarction and reduce the misdiagnosis rate.

Clinical value in early diagnosis of myocardial damage with h-FABP, cTnI, Mb and CK-Mb joint detection to HFMD in children / 中国医学装备

Objective:To explore the early diagnostic value of joint detection heart type fatty acid binding protein (h-FABP), troponin (cTnI), myoglobin (Mb) and creatine kinase isoenzyme Mb (CK-Mb) in children's hand, foot and mouth disease (HFMD) combined myocardial injury.Methods: Choice 276 cases of HFMD as observation group, and 40 healthy children as control group. Were determined h-FABP, cTnI, Mb and CK-Mb content in serum at different time, analysis of various index level differences and dynamic change between groups in different period.Results: Among 276 patients with HFMD, 57 cases of diagnosed myocarditis, concurrent rate was 20.65%. Within 0~3 hrs, abnormal rate of h-FABP, cTnI, Mb and CK-Mb in serum were 20.29%,1.81%,14.86% and 2.90%, in 276 cases of children with HFMD. The abnormal rate of h-FABP and Mb was obviously higher than that of cTnI and CK-Mb, the results between the difference was statistically significant (x2=35.132,x2=37.063,P<0.01),h-FABP abnormal rate is higher than CK-Mb, the difference was statistically significant(x2=3.175,P<0.05). the,serum h-FABP cTnI, Mb and CK-Mb concentrations in children of HFDM combined with suspicious viral myocarditis were significantly higher than that of control group, the difference had statistical significance (t=37.625,t=23.172,t=17.261,t=18.724,P<0.01). H-FABP and Mb concentration on HFMD combined myocarditis began to rise after the occurrence of 0~3 h, 4~9 h to peak, CTnI and CK-MB 4~9 h to rise, 10~12 h to peak, has been in a higher level in the 12~72 h.Conclusion: HFMD combined myocarditis had a higher incidence, h-FABP is the most sensitive indicator of early diagnosis, followed by Mb. CTnI and CK-MB are parameters of diagnosis sensitivity for HFMD combined with myocarditis in middle-late period.

Changes and significance of heart-type fatty acid-binding protein and N terminal probrain natriuretic peptide in sepsis patients with myocardium injury / 实用医学杂志

Objective To investigate the clinical value of heart-type fatty acid-binding protein ( H-FABP) and N terminal probrain natriuretic peptide (NT-proBNP) in sepsis patients with myocardium injury. Methods 118 sepsis patients were included as survivor group (68 cases) and death group (50 cases) according to their prognosis outcome. 50 healthy people were selected as control group. Creatase, H-FABP, NT-proBNP, APACHEⅡscore and 28 day morbidity of control group and sepsis patients were assessed at 1 h, 6 h after admission by physical examination . Results At 1 h after admission , APACHEⅡscore , H-FABP and NT-proBNP level in sepsis patients were significantly higher than control group (P < 0.05); APACHEⅡscore, H-FABP, NT-proBNP and cTnI level at 6 h after admission were higher than that at 1 h (P < 0.05); APACHEⅡscore, H-FABP and NT-proBNP level in death group were higher than survivor group at 1, 6 h after admission (P < 0.05), cTnI level at 6 h after admission was higher in death group (P < 0.05). Futhermore, H-FABP, NT-proBNP and cTnI at 6 h after admission were positively correlated with each other (both P < 0.05). At 6 h after admission , H-FABP showed a better predictive value of 28-day mortality than NT-proBNP and APACHEⅡscore (P < 0.05). Conclusion H-FABP and NT-proBNP may suggest important significance in early diagnosis and prognosis prediction of sepsis patients with myocardium injury.

The Prognostic Value of Serum Levels of Heart-Type Fatty Acid Binding Protein and High Sensitivity C-Reactive Protein in Patients With Increased Levels of Amino-Terminal Pro-B Type Natriuretic Peptide

BACKGROUND: Amino-terminal pro-B type natriuretic peptide (NT-proBNP) is a well-established prognostic factor in heart failure (HF). However, numerous causes may lead to elevations in NT-proBNP, and thus, an increased NT-proBNP level alone is not sufficient to predict outcome. The aim of this study was to evaluate the utility of two acute response markers, high sensitivity C-reactive protein (hsCRP) and heart-type fatty acid binding protein (H-FABP), in patients with an increased NT-proBNP level. METHODS: The 278 patients were classified into three groups by etiology: 1) acute coronary syndrome (ACS) (n=62), 2) non-ACS cardiac disease (n=156), and 3) infectious disease (n=60). Survival was determined on day 1, 7, 14, 21, 28, 60, 90, 120, and 150 after enrollment. RESULTS: H-FABP (P<0.001), NT-proBNP (P=0.006), hsCRP (P<0.001) levels, and survival (P<0.001) were significantly different in the three disease groups. Patients were divided into three classes by using receiver operating characteristic curves for NT-proBNP, H-FABP, and hsCRP. Patients with elevated NT-proBNP (≥3,856 pg/mL) and H-FABP (≥8.8 ng/mL) levels were associated with higher hazard ratio for mortality (5.15 in NT-proBNP and 3.25 in H-FABP). Area under the receiver operating characteristic curve analysis showed H-FABP was a better predictor of 60-day mortality than NT-proBNP. CONCLUSIONS: The combined measurement of H-FABP with NT-proBNP provides a highly reliable means of short-term mortality prediction for patients hospitalized for ACS, non-ACS cardiac disease, or infectious disease.

Clinical evaluation of H-FABP,hs-cTnI,Hcy and Cys-C in early diagnosis acute myocardial infarction / 国际检验医学杂志

Objective To study the clinical value of heart‐type fatty acid binding protein(H‐FABP) ,high‐sensitive cTnI(hs‐cT‐nI),homocysteine(Hcy)andcystatinc(Cys‐C)intheearlydiagnosisofacutemyocardialinfarction(AMI).Methods 150casesof AMI patients with coronary arteriography (AMI group) were selected from the cardiovascular department admitted within the first 6hours of chest pain attack .An additional 30 case for control group .The level of four novel cardiac marker were measured in each group of serum .Results The level of serum H‐FABP ,hs‐cTnI ,Hcy and Cys‐C in AMI group were markedly higher than control group(P<0 .05) ,and rose with the increase of coronary artery lesions with statistical difference (P<0 .05) .Each cardiac markers showed high specificity in the diagnosis of AMI ,amongst which H‐FABP and hs‐cTnI ,stood out with sensitivity of 97 .34% and 89 .98% respectively .With Youden index ,positive likelihood ration ,negative likelihood ration ,positive predictive value and negative predictive value ,H‐FABP and hs‐cTnI appeared to have higher diagnostic value than Hcy and Cys‐C in AMI .Conclusion H‐FABP and hs‐cTnI displayed significant clinical value as a most sensitive indicator in the early diagnosis of AMI (within 6 hours of attack) . The level of H‐FABP ,hs‐cTnI ,Hcy and Cys‐C elevated as coronary artery lesions increase .

Effect of Carvedilol and Bisoprolol on the Changes of Heart Type Fatty Acid Binding Protein and Brain Natri-uretic Peptide in Patients with Congestive Heart Failure / 中国药房

OBJECTIVE:To observe the changes of heart type fatty binding protein (H-FABP) and brain natriuretic peptide (BNP)when carvedilol and bisoprolol in the treatment of elderly patients with chronic heart failure(CHF). METHODS:110 CHF patients were randomly assigned into carvedilol group and bisoprolol group (n=55). Carvedilol group was given carvedilol 3.125 mg,bid,doubling dose every 2 weeks to reach target dose 25mg or maximum tolerant dose;bisoprolol group was given bisoprolol 1.25 mg,qd,doubling dose every 2 weeks to reach target dose 10 mg or maximum tolerant dose. Treatment course lasted for 6 months. Clinical effective rate of 2 groups were observed after treatment. Echocardiography was used to measure the changes of LVEDD,LVEF,SBP and DBP before and after treatment. The plasma concentration of BNP and H-FABP were measured by radio-immunoassay. RESULTS:After treatment,total effective rate of carvedilol group(96.4%)was higher than that of bisoprolol group (89.2%),with statistical significance(P<0.05). Compared with before treatment,the levels of LVEDD,LVEF,BNP,H-FABP, SBP and DBP in 2 groups were all decreased significantly after treatment,with statistical significance (P<0.01 or P<0.05). CON-CLUSIONS:Both carvedilol and bisoprolol can significantly improve cardiac function,but carvedilol efficacy is more significant. At the same time,significant decrease of H-FABP before and after treatment indicate that H-FABP can be used as a reliable index of heart failure treatment effect.

The changes and clinical significance of heart-type fatty acid binding protein and soluble ST2 protein in children with chronic heart failu re / 临床儿科杂志

ObjectiveTo study the changes and clinical significance of serum heart-type fatty acid-binding protein (H-FABP) and soluble ST2 protein (sST2) in children with chronic heart failure (CHF).MethodsThirty-nine children with CHF and 30 healthy children were recruited. Serum levels of H-FABP and sST2 were determined by ELISA, The left ventricular ejection fraction (LVEF) and fractional shortening of the left ventricle (LVFS) were measured by two-dimensional echocardiog-raphy.ResultsIn 39 children with CHF, 15 males and 24 females, aged 2 months to 14 years, included 27 cases of endocardial ifbroelastosis (EFE) and 12 cases of dilated cardiomyopathy (DCM). According to the cardiac functional grading standard, the children with CHF were divided into 10 cases with cardiac function II, 15 cases with cardiac function III, and 14 cases with cardiac function IV. The mean levels of H-FABP, sST2 and NT-Pro-BNP in children with CHF at stage of heart failure and heart failure remission were statistically higher than those in the healthy children (allP0.05). The Spearman correlation analysis showed that, in children with CHF at stage of heart failure, the serum H-FABP level was positively correlated with NT-Pro-BNP, sST2 and cardiac function (r=0.402、0.621、0.644,P<0.05). Serum sST2 level was positively correlated with NT-Pro-BNP and cardiac function (r = 0.501、0.678,P<0.05), and was negatively correlated with LVEF and LVFS (r=?0.340、?0.329, P<0.05).ConclusionsH-FABP and sST2 are involved in the development of heart failure. H-FABP and sST2 can be used as reference indices for clinical diagnosis and assessment of CHF.

Application of ischemia modified albumin and heart-type fatty acid-binding protein for the diagnosis and risk stratification of unstable angina / 国际检验医学杂志

Objective To determine the value of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natri-uretic peptide and homocysteine in the risk stratification of patients with unstable angina pectoris;thus to provide an assessment for the condition of patients in clinic.Methods 135 patients with unstable angina were included in the disease group and subjected to risk stratification according to GRACE risk score software,70 cases of low-risk group,60 cases in the middle-risk group and 5 cases in the high-risk group.Another 145 healthy people were in the control group.The levels of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine were detected and compared.Results Between the control group and the disease group,significant difference of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocys-teine was found (P 0.05).In the dis-ease group,the levels of ischemia modified albumin,heart-type fatty acid-binding protein and homocysteine in each risk stratification showed no significant difference(P >0.05).The level of B-type natriuretic peptide in high-risk group was higher than that in the low-risk group and in the middle-risk group and the difference was statistically significant (P 0.05 ).Conclusion The detection of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine possesses certain meaning in diagnosing unstable angi-na,and the level of B-type natriuretic peptide indicates the risk degree of the disease.

Application of the glycogen phosphorylase BB and heart-type fatty acid binding protein to the early diagnosis of neonatal myocardial injury / 实用医学杂志

Objective To evaluate the efficiency of glycogen phosphorylase BB (GPBB) and heart-type fatty acid binding protein (H-FABP) in the early diagnosis of neonatal myocardial injury (NMI). Methods The GPBB and H-FABP levels in the blood were detected at 3, 6, 12 and 24 h after onset of the NMI. The GPBB and H-FABP levels were compared among NMI, Non-NMI and control groups. The NMI diagnosis sensitivity and specificity for GPBB, H-FABP, GPBB combined with H-FABP were compared. The relationships of GPBB, H-FABP levels with the risk factors were analyzed. Results The GPBB and H-FABP levels of NMI group were higher than those of Non-NMI and control groups (P < 0.01). The diagnosis sensitivity of four time points (3, 6, 12 and 24 h) of combined GPBB and H-FABP were higher than those of the GPBB and H-FABP (P < 0.05). The GPBB and H-FABP were negatively correlated with blood glucose level, positively correlated with asphyxia degree and septicemia degree. Conclusion The combined application of GPBB and H-FABP can improve sensitivity in the early diagnosis of NMI.

Influence of lovastatin calcium on serum ET-1, PAO, H-FABP, VEGF, S100β, inflammatory cytokines and nerve function patients with acute cerebral infarction / 中国生化药物杂志

Objective To investigate the effect of atorvastatin calcium on serum endothelin-1(ET-1), polyamine oxidase(PAO), heart-type fatty acid binding protein(H-FABP), vascular endothelial growth factor(VEGF), 100β, inflammatory cytokines and nerve function in patients with acute cerebral infarction.Methods According to the random number table, 113 patients were randomly divided into two groups (n=61) and control group (n=52).The control group received conventional treatment methods, and observation group received atorvastatin calcium on the basis of control group. The treatment course was two weeks.Serum ET-1, PAO, H-FABP, VEGF, S100β, inflammatory cytokines and NIHSS score were compared between two groups before treatment, 7d and 14d after treatment.Results The serum levels of ET-1, PAO, H-FABP after 7d, 14d treatment of observation group was significantly lower than that of control group, respectively (P<0.05).The VEGF level of observation group after 7 d, 14 d treatment of observation group was significantly higher than that of control group, respectively (P<0.05).The S100βlevel after 7 d, 14 d treatment of observation group was significantly lower than that of control group, respectively (P<0.05).The hs-CRP, IL-8, TNF-αlevels after 7 d, 14 d treatment of observation group was significantly lower than that of control group, respectively (P<0.05).NIHSS score after treatment of observation group was significantly lower than that of control group (P<0.05).Conclusion The atorvastatin calcium can improve neurological function in patients with brain injury through reducing serum ET-1, PAO, H-FABP and S100βlevels, promote angiogenesis through increasing VEGF expression, and alleviate inflammation and ischemia-reperfusion injury through reducing inflammatory cytokines, thereby promote neurological functional recovery.