Heart-type Fatty Acid-binding Protein Research Articles

Utility of detection test for heart-type fatty acid–binding protein in postmortem blood

Utility of detection test for heart-type fatty acid–binding protein in postmortem blood

Serum heart-type fatty acid-binding protein as a predictor for the development of sepsis-associated acute kidney injury

ABSTRACTBackground: We analyzed the correlation between heart-type fatty acid-binding protein (HFABP) and the development of acute kidney injury (AKI) in patients with sepsis and estimated the predictive capacity of HFABP for sepsis-associated acute kidney injury (SAKI).Methods: In this retrospective observational study, we screened 2,452 patients who received the HFABP test in the emergency department. 442 admitted patients with sepsis were finally enrolled. Based on the diagnostic criteria for AKI in Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, patients were divided into the no-AKI group (n = 317) and AKI group (n = 125). We analyzed the correlation between HFABP and SAKI occurrence by logistic regression analysis and evaluated the predictive ability of HFABP to SAKI using c-index, net reclassification improvement index (NRI) and integrated discrimination improvement index (IDI).Results: Patients in the AKI group with significantly higher the level of HFABP and in-hospital mortality. HFABP concentration is an independent risk factor for SAKI (OR: 11.398; 95% CI: 6.218–20.891, P < 0.001), but not for in-hospital mortality (OR: 1.189, 95%CI: 0.954–2.607, P = 0.076). The addition of HFABP to the prediction model significantly improved the ROC area (0.867 vs 0.755, P < 0.001), NRI 25.03% (95% CI 9.72–38.51%) and IDI 14.33 (95% CI 11.04–17.62).Conclusion: Serum HFABP is correlated with SAKI development and could become a potential predictive biomarker.

Could heart-type fatty acid binding protein predict clinical outcome in coronary artery bypass graft surgery?

Background: Detection of myocardial damage and its degree during open heart surgery were studied previously using different biomarkers. Heart fatty acid binding protein (h-FABP) was used in the diagnosis of myocardial infarction with variable results. In this study, we aimed to find the possibility of the use of this biomarker as a predictor of myocardial damage after coronary artery bypass graft (CABG) surgery.&#x0D; Methods: We conducted a prospective study on 47 patients who had CABG surgery. Blood samples (4 ml) were drawn from patients at 5 points: before induction of anesthesia, after aortic declamping, 1 hour after declamping, 6 hours after declamping and one day after surgery. Levels of h-FABP and creatine kinase muscle/brain (CK-MB) were estimated, and the relationship between h-FABP and operative and postoperative outcomes were recorded.&#x0D; Results: There were statistically significant correlations between higher levels of h-FABP measured immediately after aortic declamping and need for intra-aortic balloon (116.55 + 9.26 vs, 84.34 + 19.55 ng/ml; p= 0.022), inotropes (107.04+ 14.79 vs, 79.95 + 17.59ng/ml; p&lt; 0.001), defibrillators (97.73 + 15.18 vs 81.59 + 20.31 ng/ml; p=0.016), and postoperative atrial fibrillation (99.94 + 17.83 vs 80.84 + 18.89ng/ml; p= 0.004). No mortality was detected in our study. h-FABP levels showed an early peak just after aortic declamping and reached baseline by postoperative day one. CK-MB peaked 1 hour after aortic declamping and remained elevated for more than 24 hours.&#x0D; Conclusion: h-FABP is a cardiac biomarker that could be used as a rapid indicator of ventricular dysfunction and atrial fibrillation post-CABG surgery.

Evaluating possible acute coronary syndrome in primary care: the value of signs, symptoms, and plasma heart-type fatty acid-binding protein (H-FABP). A diagnostic study.

BackgroundAdditional diagnostic means could be of added value when evaluating possible acute coronary syndrome (ACS) in primary care.AimTo determine whether heart-type fatty acid-binding protein (H-FABP)-based point-of-care (POC) biomarker testing, embedded in a clinical decision rule (CDR), is helpful to the GP when evaluating possible ACS.Design & settingA prospective, non-randomised, double-blinded, diagnostic derivation study was undertaken, with a delayed-type cross-sectional diagnostic model among GPs in the Netherlands and Belgium.MethodSigns and symptoms predicting acute myocardial infarction (AMI) or ACS were identified using both logistic regression analysis, and classification and regression trees (CART). Diagnostic values of the POC H-FABP test (cut-off value 4 ng/ml) alone and as part of a CDR were determined.ResultsA total of 303 participants (48.8% male) with chest pain or discomfort who had consulted a GP were enrolled. ACS was found in 32 (10.6%) of these 303 patients. For ACS, sensitivity and negative predictive value (NPV) of the POC H-FABP test was 25.8% (95% confidence interval [CI] = 12.5 to 44.9) and 91.6% (95% CI = 87.6% to 94.5%), respectively. The area under the receiver operating curve of the optimal CDR was 0.78 for ACS.ConclusionSensitivity of the current H-FABP POC test (cut-off value 4 ng/ml) as a stand-alone test is poor, either owing to limitations of the marker or of the test device. Usability of a CDR derived from these results is doubtful: the number of ACS cases missed by the GP is reduced but, as a consequence, disproportionally more ACS-negative patients are referred.

Heartbreakers-Cardiac Stress After Uncomplicated Generalized Convulsive Seizures.

Adult patients with refractory epilepsy who underwent video-electroencephalography monitoring along with simultaneous one-lead electrocardiography recordings were included. Cardiac biomarkers (cardiac troponin I [cTNI]; high-sensitivity troponin T [hsTNT]; N-terminal prohormone of brain natriuretic peptide; copeptin; suppression of tumorigenicity-2 [SST-2]; growth differentiation factor 15, [GDF-15]; soluble urokinase plasminogen activator receptor [suPAR]; and heart-type fatty acid binding protein [HFABP]) and catecholamines were measured at inclusion and at different time points after GCS. Peri-ictal cardiac properties were assessed by analyzing heart rate (HR), HR variability (HRV), and corrected QT intervals (QTc). Thirty-six GCS (6 generalized-onset tonic-clonic seizures and 30 focal to bilateral tonic-clonic seizures) were recorded in 30 patients without a history of cardiac or renal disease. Postictal catecholamine levels were elevated more than 2-fold. A concomitant increase in HR and QTc, as well as a decrease in HRV, was observed. Elevations of cTNI and hsTNT were found in 3 (10%) of 30 patients and 6 (26%) of 23 patients, respectively, which were associated with higher dopamine levels. Copeptin was increased considerably after most GCS, whereas SST-2, HFABP, and GDF-15 displayed only subtle variations, and suPAR was unaltered in the postictal period. Cardiac symptoms did not occur in any patient. The use of more sensitive biomarkers such as hsTNT suggests that signs of cardiac stress occur in about 25% of the patients with GCS without apparent clinical symptoms. Soluble urokinase plasminogen activator receptor may indicate clinically relevant troponin elevations. Copeptin could help to diagnose GCS but specificity needs to be tested.

New Cardiovascular Biomarkers in Ischemic Heart Disease—GDF-15, A Probable Predictor for Ejection Fraction

Background: Various biomarkers have been associated with coronary artery disease (CAD) and ischemic heart failure. The aim of this study was to investigate the correlation of serum levels of soluble urokinase-type plasminogen activator receptor (suPAR), growth differentiation factor 15 (GDF-15), heart-type fatty acid-binding protein (H-FABP), and soluble suppression of tumorigenicity 2 (sST2) with left ventricular ejection fraction (EF) in CAD patients and controls. Methods and Results: CAD patients were divided into three groups according to their EF as measured by the biplane Simpson method (53–84%, 31–52%, ≤30%). Overall, 361 subjects were analyzed. In total, 155 CAD patients had an EF of 53–84%, 71 patients had an EF of 31–52%, and 23 patients had an EF of ≤30% as compared to 112 healthy controls (age 51.3 ± 9.0 years, 44.6% female). Mean ages according to EF were 62.1 ± 10.9, 65.2 ± 10.1, and 66.6 ± 8.2 years, respectively, with females representing 29.0, 29.6, and 13.0%. suPAR, GDF-15, H-FABP, and sST2 values were significantly higher in CAD patients and showed an exponential increase with decreasing EF. In a multiple logistic regression model, GDF-15 (p = 0.009), and NT-brain natriuretic peptide (p = 0.003) were independently associated with EF. Conclusion: Biomarkers such as suPAR, GDF-15, H-FABP, and sST2 are increased in CAD patients, especially in highly impaired EF. Besides NT-proBNP as a well-known marker for risk prediction, GDF-15 may be an additional tool for diagnosis and clinical follow-up.

Is there a place for heart-type fatty acid binding protein in the era of high-sensitive cardiac troponin T for the diagnosis of acute myocardial infarction? A systematic review

Early recognition of myocardial infarction (MI) remains a challenge, especially in patients presenting with non-ST-segment elevation MI. Heart-type fatty acid binding protein (hFABP) has shown to be a more sensitive marker for myocardial necrosis as compared to non-high sensitive troponins (4th generation and older). However, since high sensitive troponin (hs TnT) assays are available, it is questionable whether hFABP still has value as a diagnostic tool for MI. A systematic search was conducted in Medline, Embase and Cochrane. After selecting the articles, they were assessed for risk of bias according to the QUADAS-2 criteria. Negative predictive value, positive predictive value, sensitivity and specificity were extracted or calculated if possible. Nine studies met the inclusion criteria. Overall, hs TnT showed higher sensitivity than hFABP, while hFABP had higher specificity. In patients presenting within 3 hours after onset of symptoms, sensitivity is low for both hFABP and hs TnT (19-63% vs 25-55%, respectively), while specificity seems higher for hFABP than for hs TnT (70-99% vs 57-86%, respectively). In these patients, the area under the curve for hs TnT is equal or better than that for hFABP (0.67-0.92 for hs TnT vs 0.69-0.85 for hFABP). The addition of hFABP to hs TnT did not improve sensitivity and specificity. This systematic review finds no advantage for using hFABP over hs TnT in either early presenting patients or overall. Furthermore, no advantage was found if a combination of hFABP and hs TnT was used for the diagnosis of MI.

Signal-Enhanced Detection of Multiplexed Cardiac Biomarkers by a Paper-Based Fluorogenic Immunodevice Integrated with Zinc Oxide Nanowires.

Using a single test to comprehensively evaluate multiple cardiac biomarkers for early diagnosis and prevention of acute myocardial infarction (AMI) has faced enormous challenges. Here, we have developed paper-based fluorogenic immunodevices for multiplexed detection of three cardiac biomarkers, namely, human heart-type fatty acid binding protein (FABP), cardiac troponin I (cTnI), and myoglobin, simultaneously. The detection is based on a strategy using zinc oxide nanowires (ZnO NWs) to enhance fluorescence signals (∼5-fold compared to that on pure paper). The immunodevices showed high sensitivity and selectivity for FABP, cTnI, and myoglobin with detection limits of 1.36 ng/mL, 1.00 ng/mL, and 2.38 ng/mL, respectively. Additionally, the paper-based immunoassay was rapid (∼5 min to complete the test) and portable (using a homemade chamber with a smartphone and an ultraviolet lamp). The developed devices integrated with ZnO NWs enable quantitative, sensitive, and simultaneous detection of multiple cardiac biomarkers in point-of-care settings, which provides a useful approach for monitoring AMI diseases and may be extended to other medical diagnostics and environmental assessments.

Prognostic value of the cardiac fraction of fatty acid binding protein in patients with non-ST elevation acute coronary syndrome with concomitant type 2 diabetes

Aim. To study the association between a positive results of Heart-type fatty acid binding protein (h-FABP) test with the development of adverse outcomes during the year of observation in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) depending on the type 2 diabetes mellitus (DM-2) presence.Material and methods. The study included 153 patients with NSTEACS hospitalized in the department of emergency cardiology in the period from March 2014 to January 2017. In addition to the standard examination, all patients underwent a qualitative analysis on the h-FABP in venous blood. Results. Kaplan–Meier estimator demonstrated a significant probability of a combined end point in patients with positive h-FABP, both with and without DM-2. H-FABP also acts as a marker for the development of adverse outcomes during the year after NSTE-ACS. Patients with adverse outcomes and type 2 diabetes mellitus had the highest frequency (100%) of positive test reactions.Conclusion. H-FABP positive test when admitted to hospital may be considered as a predictor of adverse long-term outcomes in patients with NSTE-ACS. That statistics is most significant for patients with DM-2.

Serum fatty acid binding proteins as a potential biomarker in atrial fibrillation.

Atrial fibrillation (AF) is a commonly occurring arrhythmia which significantly reduces patients' quality of life and substantially shortens life expectancy. Although long chain fatty acids (LCFAs) are the basic energy substrates for myocardial metabolism, their excess can result in lipotoxicity, which increases the risk of arrhythmia. Intracellularly, LCFAs are bound by fatty acid biding proteins (FABPs) and this results in low level of free LCFAs in the cytoplasm. Based on this principle, FABPs are considered "safeguards" against overwhelming accumulation of esterified into different bioactive lipid fractions (e.g. ceramide, diacylglycerols) LCFAs. So far, several FABPs have been discovered in humans. Currently, in relation to cardiovascular diseases heart-type fatty acid binding protein (H-FABP) and adipocyte fatty acid binding protein (A-FABP) play significant roles. Nowadays, A-FABP is of great interest for research related with obesity, diabetes and coexisting disorders including cardiovascular diseases. Concomitantly, H-FABP is already well-established marker in the early diagnosis of myocardial infarction. Moreover, FABPs were assigned as a potential biomarker of AF in patients with de novo diagnosed arrhythmia, chronic heart failure (CHF), and in patients undergoing cardiac surgery. Another group of studies where the concentrations of plasma FABPs were analyzed are patients subjected to electrical cardioversion (ECV) and radio-catheter ablation therapy (RFA). It is worth mentioning that, in addition to traditional anti-arrhythmic drugs (AADs) or ECV, ablation techniques are used with good effects. Even though the treatment of arrhythmias is constantly developing, the maintenance of the sinus rhythm (SR) is still a serious problem. Therefore, it is worth looking for a biomarker which is suitable for the patient's treatment qualifications as well as assessing its effectiveness. Thus, the aim of this work is to present current data on the clinical significance of FABPs in terms of the development and treatment of AF.

Effects of Remote Ischemic Preconditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery.

PurposeThis study aimed to evaluate effects of remote ischemic preconditioning (RIPC) on myocardial injury in patients undergoing off-pump coronary artery bypass graft surgery (OPCABG).MethodsSixty-five patients scheduled for the OPCABG were randomly assigned to control (n = 32) or RIPC group (n = 33). All patients received general anesthesia. Before the surgical incision, RIPC was induced on an upper limb with repeated 5-min ischemia and 5-min reperfusion for four times. Blood samples were collected from right internal jugular vein. Plasma levels of IL-6, IL-8, IL-10, TNF-α, cTnT, HFABP, IMA, and MDA were detected at pre-operatively and 0, 6, 18, 24, 48, 72, and 120 h after the surgery. Left internal mammary artery (LIMA) and great saphenous vein (GSV) was cut into 2–3 mm for Western blot analysis of Hif-1α.ResultsIn the present study, RIPC treatment significantly reduced plasma levels of cardiac troponin T (p < 0.05), heart-type fatty acid binding protein (p < 0.05), ischemia modified albumin (p < 0.05), malondialdehyde (p < 0.05), as well as plasma levels of pro-inflammatory cytokines including IL-6, IL-8, and TNF-α (P < 0.05, respectively). RIPC treatment significantly increased hypoxia-inducible factor-1α (p < 0.05) expression as well. Mechanical ventilation time for postoperative patients was shortened in RIPC group than those in control group (17.4 ± 3.8 h vs. 19.7 ± 2.9 h, respectively, p < 0.05).ConclusionRIPC by upper limb ischemia shortens mechanical ventilation time in patients undergoing OPCABG. RIPC treatment reduces postoperative myocardial enzyme expression and pro-inflammatory cytokine production. RIPC is a protective therapeutic approach in the coronary artery bypass graft surgery.

Diagnostic performance of heart-type fatty acid binding protein and high sensitive-cardiac troponin in patients in an emergency department sus-pected of acute myocardial infarction

Heart-type fatty acid binding protein (H-FABP) also referred to as mammary­ derived growth inhibitor is a polypeptide structure that in humans transcribed by FABP3 gene. It is preferred to be investigated in combination with troponin to the diagnosis of myocardial infarction in patients suffering from chest pain. This study aims to evaluate the role of H­ FABP in early diagnosis of MI in comparison with new generation cardiac troponin (hs-c'Tn) and to differentiate patients with ischemic chest pain from non-ischemic ones. This case-control study was performed at the Department of Biochemistry, Medical school, University of Baghdad, during the period from December 2017 to August 2018. It involved 36 patients presented with chest pain; 18 ischemic patients (AMI) and 18 non- ischemic patients (non-AMI) who served as pathological control. Serum investigations included measurements of FABP and hs-c'I'n using enzyme-linked immunosorbent assay (ELISA) method. The mean (±SD) value of serum FABP levels at 1-3 hours did not differ significantly between ischemic and non- ischemic subjects, while it was significantly increased at 6-9 hours in ischemic patients (p&lt; 0.001). However, the mean value of serum levels of hs-c'I'n was significantly higher in AMI patients than in non- AMI ones at 1-3 hours (p&lt;O.0. 04) and 6-9 hours (u&lt;O.o. m). The results concluded that serum hs-c'Tn still the best biochemical marker in confirming the diagnosis of early acute MI and is superior of H-FABP in the rule in and rule out of MI.

Inhibition of MPTP-induced α-synuclein oligomerization by fatty acid-binding protein 3 ligand in MPTP-treated mice

Accumulation and aggregation of α-synuclein (αSyn) triggers dopaminergic (DAergic) neuronal loss in Parkinson's disease (PD). This pathological event is partly facilitated by the presence of long-chain polyunsaturated fatty acids (LC-PUFAs), including arachidonic acid. The intracellular transport and metabolism of LC-PUFAs are mediated by fatty acid-binding proteins (FABPs). We previously reported that heart-type FABP (FABP3) interacts with αSyn, thereby promoting αSyn oligomerization in DAergic neurons in the substantia nigra pars compacta (SNpc) following 1-methyl-1,2,3,6-tetrahydropyridine (MPTP) treatment. This αSyn oligomerization is prevented in Fabp3 gene knock out mice. We document a novel FABP3 ligand, MF1 (4-(2-(1-(2-chlorophenyl)-5-phenyl-1H-pyrazol-3-yl)phenoxy)butanoic acid), that inhibits αSyn accumulation in DA neurons, thereby inhibiting the oligomerization of αSyn, loss of DAergic neurons, and PD-like motor deficits in MPTP-treated mice. Chronic oral administration of MF1 (0.3 or 1.0 mg/kg/day) significantly improved motor impairments and inhibited MPTP-induced accumulation and oligomerization of αSyn in the SNpc, and in turn prevented loss of tyrosine hydroxylase (TH)-positive cells in the SNpc. MF1 administration (0.1, 0.3, or 1.0 mg/kg/day) also restored MPTP-induced cognitive impairments. Although chronic administration of l-DOPA (3,4-dihydroxl-l-phenylalanine; 25 mg/kg/day, i.p.) also improved motor deficits, it failed to improve the cognitive impairments. In addition, l-DOPA failed to inhibit DAergic neuronal loss and αSyn pathologies in the SNpc. In summary, the novel FABP3 ligand MF1 rescues MPTP-induced behavioural and neuropathological features, suggesting that MF1 may be a disease-modifying drug candidate for synucleinopathies.

Is the cardioprotective effect of the ACE2 activator diminazene aceturate more potent than the ACE inhibitor enalapril on acute myocardial infarction in rats?

Myocardial infarction is a major cause of cardiac dysfunction. All components of the cardiac renin-angiotensin system (RAS) are upregulated in myocardial infarction. Angiotensin-converting enzyme (ACE) and ACE2 are key enzymes involved in synthesis of components of RAS and provide a counter-regulatory mechanism within RAS. We compared the cardioprotective effect of the ACE2 activator diminazene aceturate (DIZE) versus the ACE inhibitor enalapril on post acute myocardial infarction (AMI) ventricular dysfunction in rats. Adult male rats received subcutaneous injections of either saline (control) or isoproterenol (85 mg/kg) to induce AMI. Rats with AMI confirmed biochemically and by ECG, were either left untreated (AMI) or administered DIZE (AMI + DIZE) or enalapril (AMI + enalapril) daily for 4 weeks. DIZE caused a significant activation of cardiac ACE2 compared with enalapril. DIZE caused a significantly greater enhancement of cardiac hemodynamics. DIZE also caused greater reductions in heart-type fatty acid binding protein (H-FABP), β-myosin heavy chain (β-MYH), and in heart mass to total body mass ratio. These results indicated that activation of cardiac ACE2 by DIZE enhanced the protective axis of RAS and improved myocardial function following AMI, whereas enalapril was not sufficient to restore all cardiac parameters back to normal.

Development of a Quantitative Detection Card for Heart-type Fatty Acid-binding Protein based on Background Fluorescence Quenching Immune Chromatography.

SummaryBackgroundTo establish a fast and simple quantitative method for detection of heart-type fatty acid-binding protein (H-FABP) in serum based on a background fluorescence quenching immunochromatographic assay.MethodsA detection card based on the double-antibody sandwich double-antibody method with background fluorescence quenching was developed for quantitative measurement of H-FABP in serum. The optimal concentrations of control for coating the test and control lines were determined as well as the concentrations of gold-labeled antibodies used in preparing the detection system. The detection method for H-FABP in serum was established and validated using real-world clinical samples.ResultsThe optimal concentrations of labeling antibody and coating antibody were 5.0 μg/mL and 1.0 mg/mL, respectively. The test card had a sensitivity of 1.15 ng/mL over a linear concentration range of 0–100 ng/mL. Based on three batches prepared for testing the card, the relative standard deviation (RSD) within batches was less than 15% without a significant difference (P=0.942). The detection method was tested against common interfering substances in serum, such as bilirubin, triglyceride and serum anticoagulants ethylenediamine tetraacetic acid (EDTA), heparin, and sodium citrate, and no significant cross-reaction was detected. The test method was further validated with 50 clinical serum samples, and the test results were comparable with standard reference detection methods with good correlation (R=0.95).ConclusionOur study presents a new method with strong specificity and sensitivity for the detection of H-FABP in serum, which could promote H-FABP detection in a broad range of applications.

Higher Heart-type Fatty Acid Binding Protein Levels are Related to More Severe and Extensive Coronary Atherosclerosis in Patients with Acute Myocardial Infarction

Higher Heart-type Fatty Acid Binding Protein Levels are Related to More Severe and Extensive Coronary Atherosclerosis in Patients with Acute Myocardial Infarction

Effect of dexmedetomidine pretreatment on JAK/STAT signaling pathway during myocardial injury induced by liver ischemia-reperfusion in rats

Objective To investigate the effect of dexmedetomidine pretreatment on Janus kinase/signal transducer and activator of transcription(JAK/STAT)signaling pathway during myocardial injury induced by liver ischemia-reperfusion(I/R)in rats. Methods Twenty-four healthy adult male Sprague-Dawley rats, aged 8-10 weeks, weighing 220-250 g, were divided into 3 groups(n=8 each)using a random number table method: sham operation group(group S), liver I/R group(group I/R), and dexmedetomidine pretreatment group(group D). The portal vein, superior and inferior vena cava, subhepatic inferior vena cava and hepatic artery were clamped, and the liver was perfused with 4 ℃ lactated Ringer′s solution for 60 min through the portal vein to establish the model of liver cold I/R in anesthetized rats.Dexmedetomidine 100 μg/kg was intraperitoneally injected at 30 min before ischemia in group D. Blood samples were collected at 8 h of reperfusion from the inferior vena cava for determination of serum cardiac troponin Ⅰ (cTnI) and heart-type fatty acid binding protein(H-FABP)concentrations(using the automatic biochemistry analyzer), tumor necrosis factor-alpha(TNF-α)and high-mobility group box 1 protein(HMGB1)concentrations(by enzyme-linked immunosorbent assay). The rats were then sacrificed, and hearts were harvested for examination of histopathological changes(with a light microscope)and for determination of the malondialdehyde(MDA)content(using thiobarbituric acid method)and superoxide dismutase(SOD)activity(by xanthine oxidase method), and expression of phosphorylated STAT1 and STAT3(p-STAT1, p-STAT3)and phosphorylated JAK2(p-JAK2)in myocardial tissues(by Western blot). Results Compared with group S, the serum concentrations of cTnI, H-FABP, TNF-α and HMGB1 were significantly increased, the MDA content was increased, the SOD activity was decreased, and the expression of p-JAK2, p-STAT1 and p-STAT3 was up-regulated in I/R and D groups(P<0.05). Compared with group I/R, the serum concentrations of cTnI, H-FABP, TNF-α and HMGB1 were significantly decreased, the MDA content was decreased, the SOD activity was increased, the expression of p-JAK2, p-STAT1 and p-STAT3 was down-regulated(P<0.05), and pathological changes of myocardium were significantly attenuated in group D. Conclusion The mechanism by which dexmedetomidine pretreatment mitigates myocardial injury induced by liver cold I/R may be related to inhibiting activation of JAK/STAT signaling pathway in rats. Key words: Dexmedetomidine; Reperfusion injury; Liver; Myocardium; Janus kinase; Activating transcription factor

Blood markers of cardiac stress after generalized convulsive seizures.

Generalized convulsive seizures (GCS) are associated with high demands on the cardiovascular system, thereby facilitating cardiac complications. To investigate occurrence, influencing factors, and extent of cardiac stress or injury, the alterations and time course of the latest generation of cardiac blood markers were investigated after documented GCS. Adult patients with refractory epilepsy who underwent video-electroencephalography (EEG) monitoring along with simultaneous one-lead electrocardiography (ECG) recordings were included. Cardiac biomarkers (cardiac troponin I [cTNI]; high-sensitive troponin T [hsTNT]; N-terminal prohormone of brain natriuretic peptide [NT-proBNP]; copeptin; suppression of tumorigenicity-2 [SST-2]; growth differentiation factor 15, [GDF-15]; soluble urokinase plasminogen activator receptor [suPAR]; and heart-type fatty acid binding protein [HFABP]) and catecholamines were measured at inclusion and at different time points after GCS. Periictal cardiac properties were assessed by analyzing heart rate (HR), HR variability (HRV), and corrected QT intervals(QTc). Thirty-six GCS (6 generalized-onset tonic-clonic seizures and 30 focal to bilateral tonic-clonic seizures) were recorded in 30 patients without a history of cardiac or renal disease. Postictal catecholamine levels were elevated more than twofold. A concomitant increase in HR and QTc, as well as a decrease in HRV, was observed. Elevations of cTNI and hsTNT were found in 3 of 30 patients (10%) and 6 of 23 patients (26%), respectively, which were associated with higher dopamine levels. Copeptin was increased considerably after most GCS, whereas SST-2, HFABP, and GDF-15 displayed only subtle variations, and suPAR was unaltered in the postictal period. Cardiac symptoms did not occur in any patient. The use of more sensitive biomarkers such as hsTNT suggests that signs of cardiac stress occur in about 25% of the patients with GCS without apparent clinical symptoms. SuPAR may indicate clinically relevant troponin elevations. Copeptin could help to diagnose GCS, but specificity needs to be tested.

Acute Responses of Novel Cardiac Biomarkers to a 24-h Ultra-Marathon.

The aim of the present study was to examine the acute effect of an ultra-endurance performance on N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac specific troponin T (cTnT), creatinine kinase-myocardial band (CK-MB), high sensitive C-reactive protein (hsCRP), ischemia modified albumin (IMA), heart-type fatty acid binding protein (H-FABP) and cardiovascular function. Cardiac biomarkers were evaluated in 14 male ultra-marathoners (age 40 ± 12 years) during a 24 h ultra-marathon at five points (i.e., Pre-race; Marathon, 12-h run, 24-h run, and 48-h post-race). All subjects underwent baseline echocardiography assessment at least 10 days prior to the ultra-marathon and 48 h post-race. The average distance covered during the race was 149.4 ± 33.0 km. Running the ultra-marathon led to a progressive increase in hsCRP and H-FABP concentrations (p < 0.001). CK-MB and cTnT levels were higher after a 24-h run compared to pre-race (p < 0.05). Diastolic function was altered post-race characterized by a reduction in peak early to late diastolic filling (p < 0.01). Running an ultra-marathon significantly stimulates specific cardiac biomarkers; however, the dynamic of secretion of biomarkers linked to myocardium ischemia were differentially regulated during the ultra-marathon race. It is suggested that both exercise duration and intensity play a crucial role in cardiovascular adaptive mechanisms and cause risk of cardiac stress in ultra-marathoners.

Comparisons of heart-type fatty acid-binding protein (H-FABP) levels in off-pump versus on-pump coronary artery bypass grafting.

IntroductionHeart-type fatty acid-binding protein (H-FABP) is a novel indicator of myocardial damage. The aim of the study was to compare the levels of H-FABP in off-pump and on-pump coronary artery bypass grafting (CABG).Material and methodsThirty non-randomised 30 patients who underwent CABG between January 2009 and January 2010 were enrolled in the study. Patients were divided into two equal size (n = 15) groups as group A (off-pump CABG group) and group B (on-pump CABG group). Three arterial blood samples were obtained for H-FABP after sternotomy (H-FABP 1), after the last distal anastomosis in group A and immediately after the cross clamp was removed from the aorta in group B (H-FABP 2) and 24 h after the operation (H-FABP 3). Renal and liver functions and circulating fatty acid binding protein (FABP) levels were also assessed in blood samples obtained 24 h before and 1 h after the operation.ResultsAt all three assessment points patients in group B had significantly higher H-FABP values when compared with group A. Preoperative renal and liver functions were similar in both groups and they did not differ significantly in group A and group B when preoperative and postoperative values were compared. In both groups circulating FABP levels increased in the postoperative period, and the increase was more pronounced in the on-pump CABG group.ConclusionsOn-pump surgery resulted in higher levels of H-FABP as an ischaemic marker in patients receiving coronary artery bypass surgery.