Abstract 11560: Clinical Impact of Heart-type Fatty Acid-binding Protein Levels for Predicting the Occurrence of Appropriate Implantable Cardioverter-defibrillator Shocks in Patients With Brugada Syndrome or Idiopathic Ventricular Fibrillation
Background The recent studies suggested that there were no reliable predictors of cardiac events except for prior symptoms and spontaneous type 1 ECG in Brugada syndrome (BS) patients. BS has been originally considered to occur in structural normal hearts. However, recent pathological and imaging data suggest that structural and functional changes may be present in this syndrome. We investigated whether serum levels of heart-type fatty acid binding protein (H-FABP), a marker of ongoing myocardial damage, could predict appropriate shock in BS or idiopathic ventricular fibrillation (IVF) patients with implantable cardioverter-defibrillators (ICD).
Methods and Results Between January 2000 and April 2010, 47 consecutive patients underwent ICD implantation without structural heart diseases (mean age 53 + 13 years) were enrolled. There were 30 BS and 17 IVF. H-FABP was measured before ICD implantation. During a mean follow-up period of 52.4-month, 10 appropriate shocks were observed. H-FABP were significantly higher in patients with appropriate shock than in those without (3.48 + 0.32 vs. 2.14 + 0.17ng/ml, p<0.001). There was no difference between the patients with appropriate shock and those without in terms of family history of sudden death, history of syncope, VF inducibility during electrophysiological study, and blood data (BNP and troponin T). A receiver operating characteristic analysis determined the H-FABP cut-off values for prediction of appropriate shock as 2.3 ng/mL. Multivariate Cox regression analysis revealed that high H-FABP level (> 2.3 ng/mL) was a significant independent prognostic factor for appropriate shock (HR: 13.9, 95%CI: 1.25 to 433, p=0.031). Kaplan-Meier analysis showed that patients with low H-FABP were more likely to be free of appropriate shocks than those with high H-FABP (P=0.015).
Conclusion The evaluation of H-FABP levels may be a useful tool to predict the occurrence of appropriate ICD shock in patients with BS or IVF.
- © 2012 by American Heart Association, Inc.