Abstract 1631: Ongoing Myocardial Damage for Prognosis in Patients With Heart Failure and Preserved Left Ventricular Systolic Function
Background: The presence of latent myocardial injury plays a critical role in the pathophysiology and progression of heart failure. However, the association between ongoing myocardial damage and outcomes in patients with heart failure and preserved left ventricular systolic function (HF-PSF) is still unknown. To elucidate this, we measured cardiac specific cytosolic marker (H-FABP, heart-type fatty acid binding protein) and myofibrillar component (TnT, troponin T), and analyzed clinical outcomes in patients with HF-PSF.
Methods and Results: We prospectively enrolled consecutive 200 heart failure patients (mean age, 69±13 years) with echocardiographic left ventricular ejection fraction >40%. Myocardial membrane injury [H-FABP (>4.3 ng/mL)] and myofibrillar injury [TnT (>0.01 ng/mL)] were defined by the previous researches respectively. Existence of myocardial membrane injury was more frequently observed than that of myofibrillar injury (53% vs. 34%, P<0.05). Patients were followed up with an end-point of cardiac death or re-hospitalization for 547 days. Univariate predictors of cardiac events were age, New York Heart Association class, H-FABP level, and brain natriuretic peptide level. H-FABP level was independent multivariate predictor of cardiac events (Hazard ratio: 1.17, 95% confidence interval of hazard ratio: 1.08 to 1.26, p<0.01).
Conclusion: Latent myocardial injury was commonly observed in patients with HF-PSF. Evaluation of ongoing myocardial damage using H-FABP may be a promising tool to predict patient’s outcome in HF-PSF.