Abstract 16474: Heart Type Fatty Acid Binding Protein (hFABP) in Patients with Acute Congestive Heart Failure
PURPOSE: Heart type fatty acid binding protein (hFABP) is a small cytoplasmatic protein being involved in cellular energy homeostasis. During ongoing myocardial damage hFABP is supposed to transport fatty acids from the cell membrane to mitochondria for oxidation. HFABP has been discussed as an early diagnostic marker in patients suffering from acute coronary syndromes. However, the role of hFABP in the diagnosis and prognosis of patients suffering from acute congestive heart failure (aCHF) has rarely been investigated. PATIENTS AN.
METHODS: 401 patients presenting to the emergency department with symptoms of acute dyspnea and/or peripheral edema were evaluated for this analysis. Patients were followed up to five years. Serum blood samples for measurement of hFABP (hFABP ELISA, Signosis, Inc) were collected immediately after the initial clinical presentation of the aCHF patients in the emergency department.
RESULTS: Median hFABP levels were significantly higher in patients with a history of aCHF (28.8 ng/ml, n=122) as compared to pts without aCHF (16.9 ng/ml, n=279) (P=0.0001). Median hFABP levels were significantly higher in functional NYHA class III/IV patients (27.5 ng/ml, n=128) compared to NYHA class I/II pts (19.1 pg/ml, n=70) (P=0.0001). Accordingly, median hFABP levels were significantly higher in structural ACC/AHA class C/D patients (22.7 ng/ml, n= 215) compared to class A/B pts (18.1 ng/ml, n=132) (P=0.0001). Patients with left ventricular dysfunction had significantly higher median hFABP levels (27.6 ng/ml, n=91) compared to pts without LV dysfunction (19.2 ng/ml, n=135) (P=0.0002). Mortality rates of all patients were 14% (57/401) at 1 year and 33% (129/401) at 5 years. Median hFABP levels were significantly higher in patients who died during follow-up (1 year: 28.7 ng/ml vs. 19.1 ng/ml, P=0.0009; 5 years: 26.2 ng/ml vs. 17.8 ng/ml; P=0.0001).
CONCLUSIONS: It was demonstrated that hFABP serum levels were increased in patients suffering from aCHF. HFABP was associated with functional NYHA, structural AHA/ACC classification and left ventricular dysfunction. Increased levels of hFABP might indicate patients with aCHF at higher functional or structural disease stages and might predict 1- and 5-year mortality in high risk aCHF patients.
- © 2012 by American Heart Association, Inc.