Abstract 12559: Combined Evaluation of Left Atrial Volume Index and Heart-Type Fatty Acid-Binding Protein is a Feasible Prognostic Predictor in Heart Failure Patients With Preserved Ejection Fraction
Certain parameter predicting prognosis of heart failure with preserved ejection fraction (HFpEF) remains to be determined. It was reported that left atrial volume index (LAVI) is associated with the severity of diastolic dysfunction, and poor prognosis in chronic heart failure. We previously reported that increased serum heart-type fatty acid-binding protein (H-FABP), which is released into circulation when the myocardium is injured, predicts adverse outcomes in patients with HFpEF. Therefore, we evaluated a feasibility of combined measurement of LAVI (>43 ml/ m2) and H-FABP (4.3 ng/ml) can predict poor prognosis in patients with HFpEF. We performed transthoracic echocardiography and measured serum H-FABP levels in 91 consecutive patients with HFpEF (EF ≥50%) (male/female=42/49, 75 ± 10 years old) hospitalized for heart failure. LA volume was calculated by the biplane area-length method from apical 4- and 2-chamber views at end systolic phase. There were 32 cardiac events (35%) including cardiac death or rehospitalization for HF during a median follow-up period of 400 days (range 17 – 990 days). There were no significant differences in age, the prevalence of atrial fibrillation (AF), and EF between patients with and without cardiac events. LAVI and H-FABP were markedly higher in patients with cardiac events than in those without events (LAVI, 72 ± 32 vs. 42 ± 17 ml/m2, P<0.01; H-FABP, median 6.6 vs. 4.3 ng/ml, P<0.01). The Cox multivariate proportional hazard analysis revealed that combination of high LAVI and high serum levels of H-FABP was an independent predictor for cardiac events (hazard ratio, 5.291; 95% confidence interval, 2.193–12.821; P<0.01). Kaplan-Meier analysis also showed that the combination of LAVI and H-FABP could successfully risk stratify patients for cardiac events. In conclusion, combined evaluation of LAVI and H-FABP can predict poor prognosis in patients with HFpEF.
- © 2010 by American Heart Association, Inc.