The Heart-type Fatty Acid-binding Protein (H-FABP) is a Biochemical Marker of Myocardial Injury in Acute Phase Kawasaki Disease

Abstract

Background: In acute phase Kawasaki Disease (KD), subclinical myocarditis is usually complicated. In recent studies, the heart-type fatty acid-binding protein (H-FABP) can be used as an early indicator of myocardial injury in adults. Objective: To investigate silent myocardial injury in patients with acute phase KD, we studied the serum levels of several biochemical markers for detecting evidence of myocardial injury. Patients &Methods: We sequentially measured the serum concentrations of H-FABP, myoglobin (MYO), cardiac troponin-T (cTnT), cardiac troponin-I (cTnI), and myosin light chain-I (MLC-I), before and after treatment with intravenous gammaglobulin (IVGG) in 26 acute KD patients (mean age, 2.6 +/-1.4 years; M/F=14/12). Results: The mean levels of H-FABP were 4.3 ±1.9 ng/ml before IVGG and decreased to 3.7 ±1.5 ng/ml (p<0.05) after 1 month. H-FABP was significantly elevated in 15.4%(4/26) before IVGG treatment. Despite improvement in clinical symptoms and signs after IVGG, the serum levels of H-FABP still elevated in 15.4%(4/26). The mean levels of MYO were 27.0 ±9.5 ng/ml before IVGG and decreased to 19.4± 7.2 ng/ml (p<0.05) after 1 month. However, MYO level elevated in only 3.8% (1/26) than normal range before IVGG. cTnT, cTnI, and MLC-I were within normal ranges. Conclusion: Subclinical myocarditis can be detected by serum H-FABP and MYO. cTnT, cTnI, and MLC-I were not sensitive markers for silent myocardial injury. H-FABP seems to be a more reliable biochemical marker for early detection of myocardial injury in acute phase KD. Furthermore IVGG may to exert cardioprotective effects in KD.