Abstract
BackgroundFatty acid-binding protein 4 (FABP4) (also known as adipocyte FABP or adipocyte P2) is expressed in adipocytes, macrophages, and capillary endothelial cells. Previous studies have shown associations among plasma FABP4, insulin resistance, metabolic syndrome, diabetes mellitus, greater coronary plaque burden, coronary artery disease, heart failure, and mortality. However, little is known about the relationship between FABP4 level and prolonged QT interval. The aim of this study was to investigate whether plasma FABP4 level is associated with a prolonged QT interval by analyzing 12-lead electrocardiograms (ECGs) in patients with stable angina and chronic kidney disease (CKD).MethodsThis study included 397 consecutive patients with stable angina and CKD who were enrolled in a disease management program. Plasma FABP4 concentrations were measured using enzyme-linked immunosorbent assays. A 12-lead ECG recording was obtained from each patient. We assessed the relationships between FABP4 levels (both as a continuous variable and stratified by tertile) at admission and corrected QT (QTc) prolongation.ResultsPatients with an abnormal QTc interval had higher median plasma FABP4 levels than those with borderline and normal QTc intervals (15.9 ng/mL vs. 10.2 ng/mL vs. 8.5 ng/mL, respectively, P < 0.0001). Statistically significant associations were observed between plasma FABP4 levels and QTc interval (β = 0.267, P < 0.0001). Using multivariate and trend analyses, a higher concentration of plasma FABP4 level was independently associated with QTc prolongation in patients with stable angina and CKD.ConclusionIn this study, plasma FABP4 levels were significantly higher in the patients with an abnormal QTc interval and were correlated with QTc prolongation. Further studies are required to elucidate whether plasma FABP4 plays a role in the pathogenesis of QTc prolongation.
Highlights
Fatty acid-binding protein 4 (FABP4) is expressed in adipocytes, macrophages, and capillary endothelial cells
Using multivariate and trend analyses, a higher concentration of plasma FABP4 level was independently associated with Corrected QT (QTc) prolongation in patients with stable angina and chronic kidney disease (CKD)
In this study, plasma FABP4 levels were significantly higher in the patients with an abnormal QTc interval and were correlated with QTc prolongation
Summary
Fatty acid-binding protein 4 (FABP4) ( known as adipocyte FABP or adipocyte P2) is expressed in adipocytes, macrophages, and capillary endothelial cells. The aim of this study was to investigate whether plasma FABP4 level is associated with a prolonged QT interval by analyzing 12-lead electrocardiograms (ECGs) in patients with stable angina and chronic kidney disease (CKD). QTc prolongation is very common and is associated with several risk factors in patients with chronic kidney disease (CKD) [8]. A previous study suggested that elevated inflammatory mediators and activation of the renin-angiotensin system contribute to arterial calcification and vascular atherosclerosis through enhanced production of reactive oxygen species in patients with CKD [10]. Increased levels of inflammatory mediators in patients with CKD may provoke cardiac fibrosis, vascular damage, sympathetic overactivity, and ion channel malfunction [9,10,11,12,13,14], resulting in a higher risk of cardiac arrhythmias and death
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