Serum Heart-type Fatty Acid-binding Protein Research Articles

Biomarker array for prediction of acute kidney injury after percutaneous coronary intervention for patients who had acute ST segment elevation myocardial infarction

Acute kidney injury (AKI) is a common complication after Percutaneous Coronary Intervention (PCI) for ST segment elevation myocardial infarction (STEMI) and is associated with poor outcomes. AKI is diagnosed by the dynamic change of serum Cr, but it could not predict AKI. This study aimed to evaluate a biomarker array that may fulfill this shortage. Setting: Cardiology Department, Tanta University Hospital. Design: Prospective interventional study included 280 acute STEMI patients who underwent emergency PCI. Serial samples of blood and urine were obtained at the time of admission to the hospital (T0) and PCI unit (T1) and at 12 h and 72 h (T12 and T72) after coronary revascularization to estimate levels of serum Cr, creatine phosphokinase, and heart-type fatty acid-binding protein (H-FABP) and calculation of neutrophil/lymphocyte ratio (NLR) and urinary liver-type FABP (L-FABP). AKI was diagnosed according to the recommendations of the European Renal Best Practice as the times of increased serum Cr concerning baseline level. 85 patients developed AKI. Regression analyses defined a high NLR ratio in the T0 sample as the most significant predictor for early AKI diagnosed at T1 time, while high NLR and serum H-FABP levels in T1 samples as the significant predictors for AKI defined at T12 time. However, high urinary L-FABP levels in T12 samples and high NLR are significant predictors for AKI at T72 time. Combined estimations of serum H-FABP and urinary L-FABP with the calculation of NLR could predict the oncoming AKI and discriminate its pathogenesis. The study protocol was approved by the Local Ethical Committee at Tanta Faculty of Medicine by approval number: 35327/3/22. For blindness purposes, the authors will be blinded about the laboratory results till the end of 72 h after revascularization and the clinical pathologist will be blinded about the indication for the requested investigations.

Evaluation of circulating insulin-like growth factor-1, heart-type fatty acid-binding protein, and endotrophin levels as prognostic markers of COVID-19 infection severity

BackgroundCoronavirus Disease 2019 (COVID-19) is a worldwide pandemic challenge spreading enormously within a few months. COVID-19 is characterized by the over-activation of the immune system causing cytokine storm. Insulin-like growth factor-1 (IGF-1) pathway can regulate the immune response via interaction with various implicated cytokines. Heart-type fatty acid-binding protein (H-FABP) has been shown to promote inflammation. Given the fact that coronavirus infections induce cytokines secretion leading to inflammatory lung injury, it has been suggested that H-FABP levels are affected by COVID-19 severity. Moreover, endotrophin (ETP), the cleavage product of collagen VI, may be an indicator of an overactive repair process and fibrosis, considering that viral infection may predispose or exacerbate existing respiratory conditions, including pulmonary fibrosis. This study aims to assess the prognostic capacity of circulating IGF-1, HFABP, and ETP, levels for COVID-19 severity progression in Egyptian patients.MethodsThe study cohort included 107 viral RNA-positive patients and an equivalent number of control individuals with no clinical signs of infection. Clinical assessments included profiling of CBC; serum iron; liver and kidney functions; inflammatory markers. Circulating levels of IGF-1; H-FABP, and ETP were estimated using the corresponding ELISA kits.ResultsNo statistical difference in the body mass index was detected between the healthy and control groups, while the mean age of infected patients was significantly higher (P = 0.0162) than the control. Patients generally showed elevated levels of inflammatory markers including CRP and ESR concomitant with elevated serum ferritin; D dimer and procalcitonin levels, besides the COVID-19 characteristic lymphopenia and hypoxemia were also frequent. Logistic regression analysis revealed that oxygen saturation; serum IGF-1, and H-FABP can significantly predict the infection progression (P < 0.001 each). Both serum IGF-1 and H-FABP as well as O2 saturation showed remarkable prognostic potentials in terms of large AUC values, high sensitivity/specificity values, and wide confidence interval. The calculated threshold for severity prognosis was 25.5 ng/mL; 19.5 ng/mL, 94.5, % and for IGF-1, H-FABP, and O2 saturation; respectively. The calculated thresholds of serum IGF-1; H-FABP, and O2 saturation showed positive and negative value ranges of 79–91% and 72–97%; respectively, with 66–95%, 83–94% sensitivity, and specificity; respectively.ConclusionThe calculated cut-off values of serum IGF-1 and H-FABP represent a promising non-invasive prognostic tool that would facilitate the risk stratification in COVID-19 patients, and control the morbidity/mortality associated with progressive infection.

TBICheck: a rapid test to rule-out CT scans in mild Traumatic Brain Injury patients

Introduction The TBICheck TM Rapid test is an immunochromatographic rapid test capable of assisting in the triage of patients with mild Traumatic Brain Injury (mTBI) suspected of brain lesions. It quantitatively determines heart-type Fatty Acid Binding Protein (H-FABP) levels in whole blood, serum, or plasma. The aim of the present study was to evaluate its technical performance and test it in two different cohorts of mTBI patients as a potential diagnostic tool for detecting brain lesions in patients with mTBI. Material and methods Description of the assay: Linearity and low limit of quantification (LLOQ) of TBICheck TM lateral flow assay were determined using serial dilution of standardized samples. Results were read using the TBICheck TM Reader, a mobile photometric immunoassay analyzer based on reflectance measurements to capture the optical density. Obtained results were compared to classical ELISA assays, Meso Scale Diagnostics (MSD). Patient cohorts: Two different cohorts of adult mTBI patients were included: a retrospective one including 82 patients and a prospective one including 65 patients. Values of H-FABP area under the curve (AUC), specificity (SP), sensitivity (SE) and negative predictive value (NPV) were calculated. Results The H-FABP dose response fitted a linear regression within the range of 0.5-25 ng/mL. LLOQ in blood was 0.5 ng/mL. High Spearman correlation was found (ρ=0.933, p&lt;0.001) when MSD ELISA and TBICheck TM concentrations were compared. In the retrospective cohort, when the clinical sensitivity was set at 100%, a specificity value of 32.9% was obtained. In the prospective cohort, the SP value raised to 66.1% with 100% SE, meaning that 6 out of 10 patients might be discharged on the basis of their serum H-FABP concentration at hospital admission. Conclusions The quantification of H-FABP by using the TBICheck TM Rapid test on adult mTBI patients may allow to rule out the need of a CT-scan reducing the radiation exposure and avoiding the long waiting times in emergency units. It may lead to savings in hospital resources and assists medical doctors to provide the most appropriate treatment to the patients.

Predictive Value of Heart-Type Fatty Acid-Binding Protein for Mortality Risk in Critically Ill Patients.

Our study assessed the predictive value of heart-type fatty acid-binding protein (H-FABP) for critically ill patients. 150 critically ill patients admitted to the emergency department of Beijing Chaoyang Hospital, Capital Medical University, were included in our study from August 2021 to April 2022. Serum H-FABP, procalcitonin (PCT), lactate (LAC), and other markers were determined within 1 h after admission. The Sequential Organ Failure Assessment (SOFA) score and the Acute Physiology and Chronic Health Evaluation II (APACHE II) were calculated. The independent predictors of 28-day mortality in critically ill patients were analyzed by logistic regression, and the receiver operating characteristic curve (ROC) was used to analyze the predictive value for 28-day mortality in critically ill patients. Age, APACHE II, SOFA, GCS, LAC, H-FABP, IL-6, Scr, and D-dimer were significantly different in the nonsurvivor vs. survivor groups (P < 0.05), with H-FABP correlating with cTNI, Scr, PCT, and SOFA scores (P < 0.05). Logistic regression analysis showed that H-FABP, APACHE II, LAC, and age were independent predictors for 28-day mortality in critically ill patients (P < 0.05). The AUC of ROC curve in H-FABP was 0.709 (sensitivity 72.9%, specificity 66.1%, and cut-off 4.35), which was slightly lower than AUC of ROC curve in LAC (AUC 0.750, sensitivity 58.3%, specificity 76.1%, and cut-off 1.95) and APACHE II (AUC 0.731, sensitivity 77.1%, specificity 58.7%, and cut-off 12.5). However, statistically, there was no difference in the diagnostic value of H-FABP compared with the other two indicators (Z 1 = 0.669, P = 0.504; Z 2 = 0.383, P = 0.702). But H-FABP (72.9%) has higher sensitivity than LAC (58.3%). The combined evaluation of H-FABP+APACHE II score (AUC 0.801, sensitivity 71.7%, and specificity 78.2%; Z = 2.612, P = 0.009) had better diagnostic value than H-FABP alone and had high sensitivity (71.7%) and specificity (78.2%). H-FABP, LAC, APACHE II, and age can be used as independent risk factors affecting the prognosis of critically ill patients. Compared with using the above indicators alone, the H-FABP+APACHE II has a high diagnostic value, and the early and rapid evaluation is particularly important for the adjustment of treatment plans and prognosis.

Effect of modified Wenyang Buxin decoction and routine therapy on cardiac function and serum levels of H-FABP, cTnI and Ang-2 in chronic heart failure patients

Purpose: To investigate the effect of modified Wenyang Buxin decoction and routine therapy on cardiac function and serum levels of heart-type fatty acid binding protein (H-FABP), cardiac troponin-1 (cTnI) and angiopoietin-2 (Ang-2) in chronic heart failure (CHF) patients.Methods: A total of 120 CHF patients admitted to Zhejiang Province Rongjun Hospital (from January2019 - January 2020) were selected for this study. They were randomly but equally distributed into groups A and B. All patients were given routine therapy such as diuretic treatment and detumescence, while those in group A received 150 mL of modified Wenyang Buxin decoction daily, in addition to routine therapy. At 2 months after therapy, cardiac function indices, serum H-FABP, cTnI and Ang-2 levels, hemorheology indices, traditional Chinese medicine (TCM) syndrome scores, and Chinese questionnaire of quality of life in cardiovascular patients (CQQC) scores of the two groups were evaluated.Results: After therapy, cardiac function indices, serum H-FABP, cTnI and Ang-2 levels, hemorheology indices as well as TCM syndrome score and CQQC score were significantly improved in group A, when compared with corresponding values in group B (p &lt; 0.05).Conclusion: Modified Wenyang Buxin decoction and routine therapy improves serum biomarker levels, cardiac function and quality of life, and relieves clinical symptoms of CHF in patients. Therefore, this treatment approach may be useful in the management of CHF patients.

Diagnostic Value of Echocardiography Combined with Serum h-FABP and cTnI in Myocardial Infarction and Its Evaluation Value in Left Ventricular Function.

Objective To explore the value of color Doppler echocardiography (CDE) combined with serum heart-type fatty acid-binding protein (h-FABP) and cardiac troponin I (cTnI) in the diagnosis of myocardial infarction and its evaluation value in left ventricular function. Methods A total of 44 patients with myocardial infarction who were treated in Cangzhou Central Hospital from October 2018 to February 2020 were included in the observation group, and 45 healthy subjects were included in the control group. The serum h-FABP and cTnI levels of the two groups were compared and analyzed. The coincidence rate of echocardiography plus serum h-FABP and cTnI for single diagnosis and combined diagnosis was analyzed. The left ventricular function indexes of patients with myocardial infarction in different cardiac function grades were compared, including left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac index (CI), and the ratio of peak velocity blood flow from left ventricular relaxation in early diastole to peak velocity flow in late diastole (E/A). The value of echocardiography combined with serum h-FABP and cTnI in the left ventricular function in patients with myocardial infarction was analyzed. Results The levels of serum h-FABP and cTnI in the observation group were significantly higher than those in the control group (P < 0.05). CDE plus serum h-FABP and cTnI was associated with significantly higher sensitivity, specificity, and accuracy in diagnosing myocardial infarction versus single detection (P < 0.05). The LVEDV, SV, and CI parameters were similar in patients with different cardiac function grades (P > 0.05). Compared with cardiac function grades I and II, the level of LVEF in patients with myocardial infarction in grades III and IV of cardiac function decreased, while the levels of LVEDD, LVESD, LVESV, and E/A increased (P < 0.05). The levels of serum h-FABP and cTnI in patients with myocardial infarction increased with the increase of cardiac function grades (P < 0.05). Conclusion Patients with myocardial infarction show high levels of h-FABP and cTnI, and CDE plus the detection of serum h-FABP and cTnI levels can significantly improve the detection accuracy and effectively evaluate the left ventricular function of patients with myocardial infarction, with a certain predictive value for cardiac function grading in myocardial infarction.

Relation of serum heart type fatty acid binding protein to left ventricular diastolic dysfunction in patients with type 2 diabetes and early diabetic kidney disease

AimsWe aimed to investigate the serum level of heart type fatty acid binding protein (H-FABP) and its relation to left ventricular (LV) diastolic dysfunction in patients with type 2 diabetes (T2DM) and early diabetic kidney disease (DKD). MethodsThis study was conducted on 100 T2DM patients divided into 50 patients with early DKD and 50 patients without DKD. Doppler echocardiography was used to assess LV function and serum H-FABP levels were measured using ELISA technique. Results78% of patients with DKD and 12% of patients without DKD had LV diastolic dysfunction. Among patients with DKD, those with diastolic dysfunction had significantly higher urinary albumin to creatinine ratio (UACR) (p = 0.041). H-FABP levels were significantly higher in patients with DKD (p˂0.001) and it had significant positive correlation with UACR (p = 0.009). No significant difference was found regarding serum H-FABP levels between patients with normal LV function and those with diastolic dysfunction in both study groups. ConclusionDiastolic dysfunction is a common finding among patients with T2DM. UACR, but not serum H-FABP, is significantly associated with diastolic dysfunction in patients with early DKD. Serum H-FABP level is significantly higher in early DKD and positively correlated with the level of albuminuria.

The Relationship with Serum Heart Type Fatty Acid Binding Protein and Subclinical Atherosclerosis in Patients with Hypothyroidism

Aim: To investigate the variability of Carotid intima-media thickness (CIMT) and the relationship between CIMT and serum Hearttype fatty acid binding protein (H-FABP) levels in patients with overt and subclinical hypothyroidism. We also aimed to evaluate the effect of levothyroxine treatment on these markers. Material and Methods: 40 patients with overt hypothyroidism (OH), 40 patients with subclinical hypothyroidism (SH) and 30 healthy individuals as control group were evaluated according to serum lipid and thyroid hormone panels, serum H-FABP levels and CIMT measurements. Serum H-FABP levels and CIMT of the patients in group OH were also evaluated following 6-months levothyroxine replacement treatment. Results: The levels of serum total cholesterol, LDL cholesterol and H-FABP in group OH were significantly higher (p<0.05). CIMT in group OH was also significantly higher than other groups (p<0.05). There was an insignificant slight positive correlation between serum H-FABP and CIMT. The values of serum H-FABP levels and CIMT measurements after levothyroxine treatment significantly decreased in comparison with pre-treatment period (p<0.05). Conclusion: The increased CIMT and H-FABP levels in overt hypothyroidism might be used as an indicator in determining subclinical atherosclerosis. Levothyroxine treatment might protect the patients with overt hypothyroidism in terms of cardiovascular risk by decreasing CIMT and serum H-FABP levels.

The prognostic impact of the serum heart-type fatty acid-binding protein level in patients with sepsis who were admitted to the non-surgical intensive-care unit.

Ongoing myocardial damage at the acme of the sepsis status has not been sufficiently evaluated. The clinical data of 160 sepsis patients who require intensive care and 127 outpatients with chronic heart failure (HF) were compared as a retrospective cohort study. Thereafter, the sepsis patients were divided into 3 groups according to the serum heart-type fatty acid-binding protein (H-FABP) quartiles [low H-FABP = Q1 (n = 39), middle H-FABP = Q2/Q3 (n = 81), and high H-FABP = Q4 group (n = 40)]. The H-FABP level was measured within 15 min of admission. The serum H-FABP levels in the sepsis patients [26.6 (9.3-79.0) ng/ml] were significantly higher than in the choric HF patients [6.6 (4.6-9.7) ng/ml]. A Kaplan-Meier curve showed that the survival rate of the high-H-FABP group was significantly lower than that of the middle- and low-H-FABP groups. The multivariate Cox regression analysis for the 365-day mortality showed that the high-H-FABP group (hazard ratio: 6.544, 95% confidence interval [CI] 2.026-21.140; p = 0.002) was an independent predictor of the 365-day mortality. The same trend in the prognostic impact was significantly (p = 0.015) observed in the cohort that had not been suffering from the cardiac disease before admission. The serum H-FABP level was an independent predictor of the 365-day mortality in the patients who were emergently hospitalized in the intensive-care unit due to sepsis. Ongoing myocardial damage was detected in the majority of patients with sepsis, suggesting that ongoing myocardial damage might be a candidate predictor of adverse outcomes in sepsis patients.

Relations of heart-type and brain-type fatty acid-binding proteins with postoperative cognitive dysfunction in elderly patients undergoing spinal surgery.

The aim of this study is to analyze the relations of heart-type fatty acid-binding protein (H-FABP) and brain-type fatty acid-binding protein (B-FABP) with postoperative cognitive dysfunction (POCD) in elderly patients undergoing spinal surgery. One hundred and twenty-five patients who underwent spinal surgery were enrolled in this study. According to whether patients had POCD within 5 days after surgery, the participants were divided into POCD group and non-POCD group. Before surgery and 6 h after surgery, the serum H-FABP and B-FABP contents were detected. There were 33 (26.4%) patients in POCD group, and 92 (73.60%) patients in non-POCD group. After surgery, the serum H-FABP and B-FABP contents in POCD group were significantly higher than those before surgery, respectively (p<0.05), and those in non-POCD group were significantly lower than those before surgery, respectively (p<0.05). After surgery, the serum H-FABP and B-FABP contents in POCD group were significantly higher than those in non-POCD group, respectively (p<0.05). The serum H-FABP and B-FABP contents are positively related to the occurrence of POCD in elderly patients undergoing spinal surgery.

The relationships between serum heart-type fatty acid-binding protein and right ventricular echocardiographic indices in chronic obstructive pulmonary disease.

Heart-type Fatty Acid-Binding Protein (H-FABP) has been used in the diagnosis of myocardial damage. In this study, we assessed the relationships between serum H-FABP as a marker of cardiac injury and right ventricle (RV) echocardiographic indices in patients with stable COPD. In this case-control study, 84 participants were investigated (50 COPD patients and 34 healthy subjects). After obtaining consent, 3 mL of fasting whole blood sample was collected from each of the participants to test their serum H-FABP. Echocardiography was performed on all participants by cardiologists. Serum H-FABP was found to be significantly correlated with smoking history (P<0.01), Systolic Pulmonary Artery Pressure (S-PAP), RV Wall Thickness (RV-WT), and Tricuspid annulus posts systolic excursion (TAPSE) (P<0.01 for all). RV Basal Diameter (RV-BD), RV Mid Diameter (RV-MD), and Fractional area change percentage (FAC%) were not observed to have any correlation with serum H-FABP. Also, the comparative analysis showed statistically significant differences between mean RV-MD (P<0.001), RV-BD, FAC%, S-PAP, RV-WT (P<0.001), and TAPSE (P<0.05) of patients at different GOLD stages. There was a significant correlation between the adjusted serum level of H-FABP and the airflow limitation based on FEV1 (P<0.001). The correlation between serum H-FABP and RV echocardiographic indices such as S-PAP, RV-WT, and TAPSE, can be related to RV function in COPD patients. Moreover, RV echocardiographic indices are significantly correlated with the severity of COPD as classified in various GOLD stages.

Prognostic value of serum heart-type fatty acid-binding protein in patients with sepsis: A protocol for systematic review and meta-analysis.

Sepsis is commonly acute and critical illness with high morbidity and high mortality, and requires timely diagnosis and treatment. Septic patients had elevated serum H-FABP levels, which may correlate with disease severity and mortality. However, previous studies showed that the association between H-FABP and mortality during the sepsis remains unclear. Thus, we performed a study to analyze this relationship. The electronic databases such as Cochrane Library, PubMed, Embase, Web of Science, Cochrane Clinical Trials Database, Wanfang Database, and China National knowledge Infrastructure (CNKI) were systematically searched to determine the qualified clinical trials. The study language is limited to English or Chinese. The 2 authors used Cochrane Risk of Bias Tool v.2.0 to independently check the quality of papers and extract relevant data. Comprehensive analysis of data extracted in the research using appropriate statistical methods. Evaluation of the relationship between the prognosis of patients with sepsis and serum H-FABP is the result of this study. The analysis results of this study can infer that H-FABP may be an independent risk factor for the prognosis of patients with sepsis. It is also helpful for clinical workers to make early evaluation and early treatment of patients with sepsis. The conclusions of this meta-analysis study are based on the published evidence. Therefore, moral recognition is unnecessary. DOI: 10.17605/ OSF.IO / 2V4HN.(https://osf.io/2v4hn/).

The Long-term Effect of Dobutamine on Intrinsic Myocardial Function and Myocardial Injury in Septic Rats with Myocardial Dysfunction.

Dobutamine (DOB) is recommended as an inotrope for septic patients with low cardiac output, but its long-term impact on sepsis-induced cardiomyopathy remains unclear. This study investigated the long-term effect of DOB on septic myocardial dysfunction and injury. Rats were exposed to cecal ligation and puncture (CLP), the intrinsic myocardial function, other organ functions, hemodynamics, inflammatory response, serum myocardial injury biomarkers, myocardial apoptosis, and vascular permeability were determined. At 6 h after CLP, the left ventricular ±dP/dt were significantly depressed, cardiac tumor necrosis factor-α and vascular cell adhesion molecule-1 expression were increased, but not serum cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), creatinine, and urea nitrogen concentrations in CLP group compared with controls. At 9 h after CLP, hepatic dysfunction was present in CLP rats compared with controls. At 6 h after CLP, DOB treatment did not affect hemodynamics, the left ventricular ±dP/dt, cytokine levels in serum and myocardium, as well as cardiomyocyte apoptosis and cardiac vascular hyperpermeability at 20 h after CLP. However, DOB (10.0 μg/kg) increased serum IL-10 level and improved survival in septic rats. These results indicate that the intrinsic myocardial depression occurs earlier than hepatic and renal dysfunction in sepsis and serum cTnI, NT-proBNP, and H-FABP are not suitable as early biomarkers for sepsis-induced myocardial dysfunction. Although DOB treatment (10.0 μg/kg) in the presence of myocardial dysfunction improves survival in septic rats, it neither improves myocardial function and hemodynamics nor attenuates myocardial injury at the later stage of sepsis.

Changes of Certain Metabolic and Cardiovascular Markers Fructosamine, H-FABP and Lipoprotein (a) in Patients with Hypothyroidism

Background:Disorders of thyroid gland are common in general population, and it’s the most common affecting the endocrine system after diabetes mellitus. Thyroid function regulates a wide range of metabolic parameters, as well as affects some cardiovascular disease risk factors. Fructosamine is produced by a reaction between albumin (protein) and glucose; it is used to monitor patients with diabetes for short-term glycemic changes. H-FABP is present in the cytoplasm of cardiac myocytes, and delivers fatty acids into these cells. It has been shown to increase in myocardial injury. Lipoprotein LP(a) is consist of a special apolipoprotein called apoprotein (a), and it’s recognized as a cardiovascular disease independent risk factor.Objective:To study whether certain metabolic and cardiovascular markers (fructosamine, H-FABP and lipoprotein (a) are changed in hypothyroid patients.Methods:The current study included 280 overt hypothyroid, 272 with subclinical hypothyroidism compared with 270 healthy individuals of matched age and gender. For all subjects serum (TSH, T4, T3, FBS, HbA1c, fructosamine, triglycerides, cholesterol, lipoprotein (a), and Heart-type Fatty Acid-Binding Protein (H-FABP)) was measured.Results:Serum fructosamine level significantly elevated (p value <0.05) in patient with hypothyroidism when compared with control group, and no significant change between subclinical and control groups. There is no significant change in serum H-FABP between study subjects. There is significant increase in lipoprotein (a) in patient with hypothyroidism and those with subclinical group when compared with control group.Conclusion:Serum fructosamine and level is significantly changed in patients with overt hypothyroidism when compared with euthyroid subjects. Also, we conclude that hypothyroidism increase risk of cardiovascular diseases by changing non-traditional marker such as lipoprotein (a), and no effect on H-FABP concentration.

Altered function of the left ventricle and clinical significance of heart-type fatty acid-binding protein in cardiac dysfunction among patients with sepsis.

The present study aimed to determine the clinical significance of heart-type fatty acid-binding protein (H-FABP) in patients with sepsis-induced cardiac dysfunction. A total of 30 healthy subjects served as the control group and 80 patients with sepsis were recruited for the present single-center prospective observational study for the final analysis. Among these patients, 50 developed cardiac dysfunction, while no cardiac dysfunction was detected in the remaining 30 patients. Echocardiography was performed on days 1, 3, 7 and 10 of hospitalization. Routine blood biochemistry, serum H-FABP, N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin I were also analyzed. Alterations in cardiac biomarkers and echocardiography results were compared between patients with sepsis who did and who did not develop any cardiac dysfunction to determine the time of the occurrence of sepsis-induced cardiac dysfunction. Furthermore, the significance of H-FABP in the prediction of the 28-day mortality rate was evaluated using binary logistic regression analysis for sepsis and receiver operating characteristic (ROC) curve analysis. In addition, the specificity and sensitivity of H-FABP in the prediction of sepsis-induced cardiac dysfunction were verified using ROC curve analysis. For patients with cardiac dysfunction, the levels of cardiac output (CO), stroke volume (SV), mitral early diastolic peak velocity to mitral atrial systolic peak velocity ratio (E/A) and left ventricle ejection fraction (LVEF) were relatively decreased, while the levels of H-FABP and NT-proBNP were markedly increased compared with patients with sepsis and without cardiac dysfunction. CO and SV initially increased and subsequently decreased. EF was elevated, and E/A initially decreased and subsequently increased. Furthermore, H-FABP and NT-proBNP decreased in sepsis patients with cardiac dysfunction. The results of the ROC curve and binary logistic regression analyses suggest that H-FABP was associated with the 28-day prognosis for patients with sepsis. An H-FABP level of >35.7 ng/ml was able to predict the 28-day mortality for patients with sepsis, with an area under the curve (AUC) of 0.680. Furthermore, >30.3 ng/ml was the threshold for the prediction of sepsis-induced cardiac dysfunction, and the sensitivity and specificity were 76.27 and 61.76%, respectively, with an AUC of 0.673. In summary, patients with sepsis had an increased risk of cardiac insufficiency on days 7-10 of hospitalization. In addition, H-FABP may serve as an indicator to predict the prognosis of patients with sepsis in the short term, which has a certain significance in the diagnosis of sepsis-induced cardiac dysfunction.

Serum Level of Heart Type Fatty Acid Binding Protein Before and after Treatment of Congestive Heart Failure in Children

Background: Heart failure (HF) in children is a clinical and pathophysiological syndrome that results from ventricular dysfunction, volume or pressure overload, either alone or in combination. This study aimed to estimate serum level of H-FABP before and after treatment of congestive heart failure, and correlate its level with severity of the disease. Patients and methods: The study was cohort control study. It included 30 infants and children; their ages ranged from two months to four years with heart failure diagnosed clinically and were admitted to Cardiology Unit of Pediatric Department, at Zagazig University Hospitals during the period from November 2017 to April 2018. They were divided into four groups, first group aged (2-12 month), second group (13-24 m), third group (25-36 m) and fourth group (37-48 m). Echocardiographic assessment of the heart was done using conventional Doppler echocardiography. Serum heart type fatty acid binding protein (H-FABP) level (estimated on patient admission and 1 week after treatment) was determined by quantitative sandwich enzyme linked immunosorbent assay (ELISA) technique. Results: There was a significant difference in the serum level of H-FABP in our patients before treatment (2.156 ± 1.156 ng/ml) compared with after treatment (0.882 ± 0.716 ng/ml). There was a significant positive correlation between serum H-FABP level and Ross classification. Conclusion: H-FABP may be used as diagnostic and prognostic predictor of adverse outcome in children with heart failure.

Serum Level of Heart Type Fatty Acid Binding Protein Before and after Treatment of Congestive Heart Failure in Children

Background: Heart failure (HF) in children is a clinical and pathophysiological syndrome that results from ventricular dysfunction, volume or pressure overload, either alone or in combination. This study aimed to estimate serum level of H-FABP before and after treatment of congestive heart failure, and correlate its level with severity of the disease. Patients and methods: The study was cohort control study. It included 30 infants and children; their ages ranged from two months to four years with heart failure diagnosed clinically and were admitted to Cardiology Unit of Pediatric Department, at Zagazig University Hospitals during the period from November 2017 to April 2018. They were divided into four groups, first group aged (2-12 month), second group (13-24 m), third group (25-36 m) and fourth group (37-48 m). Echocardiographic assessment of the heart was done using conventional Doppler echocardiography. Serum heart type fatty acid binding protein (H-FABP) level (estimated on patient admission and 1 week after treatment) was determined by quantitative sandwich enzyme linked immunosorbent assay (ELISA) technique. Results: There was a significant difference in the serum level of H-FABP in our patients before treatment (2.156 ± 1.156 ng/ml) compared with after treatment (0.882 ± 0.716 ng/ml). There was a significant positive correlation between serum H-FABP level and Ross classification. Conclusion: H-FABP may be used as diagnostic and prognostic predictor of adverse outcome in children with heart failure.

Diagnostic value of heart-type fatty acid-binding protein combined with echocardiography in sepsis with cardiac insufficiency

To observe the value of heart-type fatty acid-binding protein (H-FABP) and echocardiographic indexes in the diagnosis of cardiac insufficiency in sepsis. A prospective observational study was conducted. Eighty patients with sepsis admitted to the department of critical care medicine of the First Affiliated Hospital of Medical College of Shihezi University from October 2016 to January 2018 were enrolled. General clinical data such as gender, age, acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) score, hospitalization time and 28-day mortality were recorded. Echocardiographic indexes at 1, 3, 7, 10 days after diagnosis, and white blood cell (WBC), neutrophilic granulocyte percentage (N%), N-terminal pro-brain natriuretic peptide (NT-proBNP), serum H-FABP level were recorded. Sepsis patients were divided into normal cardiac function group (n = 30) and cardiac insufficiency group (n = 50) according to cardiac function, the differences of echocardiographic indexes and cardiac markers between the two groups at different time points were compared. Logistic regression was used to screen out cardiac ultrasound indexes and cardiac markers that affect the occurrence of cardiac dysfunction in sepsis patients, and then receiver operating characteristic (ROC) curve analysis was performed. Comparing the general data of the two groups, only the SOFA score of the cardiac insufficiency group was significantly higher than that of the normal cardiac function group (6.12±4.09 vs. 4.57±2.45, P < 0.05). N% and H-FABP in cardiac insufficiency group were higher than those in normal cardiac function group at the same time (N%: F = 6.973, P = 0.010; H-FABP: F = 17.303, P = 0.000). Without considering the time factor, there were significant differences in left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO), left ventricular fractional shortening (LVFS), E-point of septal separation (EPSS), isovolumic relaxation time (IVRT), E peak deceleration time (EDT), A peak duration (Ad), left ventricular systolic pulmonary vein velocity (S), blood flow velocity of pulmonary vein in early left ventricular diastolic period (D), tricuspid orifice early diastolic blood flow velocity (E'), tricuspid orifice late diastolic blood flow velocity (A'), systolic velocities of the right ventricular free wall tricuspid annulus (Sm), and pulmonary valve annulus blood flow velocity (PVBV) between the two groups. ROC curve analysis of cardiac ultrasound indicators and cardiac markers screened by Logistic regression showed that the area under ROC curve (AUC) and the positive and negative predictive values were: LVEDV was 0.636, 77.30%, 56.03%; SV was 0.779, 88.82%, 71.19%; LVEF was 0.753, 92.12%, 55.21%; CO was 0.754, 88.82%, 77.19%; LVFS was 0.728, 81.25%, 66.99%; EPSS was 0.663, 96.99%, 51.56%; IVRT was 0.775, 86.97%, 73.55%; A' was 0.908, 96.58%, 89.60%; Sm was 0.738, 93.37%, 56.77%; H-FABP was 0.673, 80.26%, 57.25%, respectively. H-FABP was tested in parallel with LVEDV, SV, LVEF, CO, LVFS, EPSS, IVRT, A', Sm, and the positive predictive values were higher than the single diagnostic test (85.45%, 93.91%, 96.72%, 94.74%, 89.43%, 98.00%, 92.00%, 99.42%, 93.60%, respectively), the negative predictive values were lower than the single diagnostic test (50.89%, 57.93%, 49.15%, 58.18%, 57.05%, 45.74%, 57.92%, 64.13%, 47.78%, respectively). Cardiac ultrasound indicators LVEDV, SV, LVEF, CO, LVFS, EPSS, IVRT, A', and Sm combined with H-FABP are of certain value in the diagnosis of sepsis-associated heart dysfunction.

H-FABP: A beacon of hope for prediabetic heart disease.

Background:Prediabetes is increasingly being studied in the context of its association with cardiovascular disease (CVD). Besides raised HbA1c and sugar levels, the major underlying defect seems to be insulin resistance (IR). Subclinical atherosclerosis, measured by high sensitivity C reactive protein (hsCRP) and carotid artery intima media thickness (CIMT) underlies the pathogenesis of CVD in prediabetes. Heart-type fatty acid binding protein (H-FABP), a novel cardiac biomarker also might have a role in predictin prediabetic heart disease.Aims:The aim of the study is to compare serum levels of H-FABP in prediabetics and controls and correlate them with the atherosclerotic markers, hsCRP and CIMT.Setting and Design:50 prediabetic patients and 50 age, sex and BMI matched controls were employed in the case control study. Serum F & PPBS, (HbA1c), fasting insulin levels were measured in cases and controls. Serum H-FABP was measured in both cases and controls. All cases and controls were subjected to bilateral CIMT measurements and Serum hsCRP levels. The values were compared between both the groups and subjected to appropriate statistical analysis.Statistical Analysis Used:Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected then non parametric test was used. Quantitative variables were compared using Independent t test/Mann-Whitney Test (when the data sets were not normally distributed) between the two groups. Qualitative variables were correlated using Chi-Square test/Fisher's Exact test. Spearman rank correlation coefficient was used to find out the correlation of various parameters with each other. Univariate linear regression was used to find out the cause and effect relationship between various parameters. A p <0.05 was considered statistically significant. The data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.Results:The mean serum levels of H-FABP among cases and controls were 6.38± 2.76ng/ml and 3.24 ± 2.47 ng/ml respectively (p <0.0001). Mean CIMT was found to be higher in prediabetics (0.59 ± 0.11 mm ) compared to controls (0.45 ± 0.07mm) (p<0.0001). Serum hsCRP levels were also statistically higher in prediabetics (5.75± 4.16 mg/l) then that of controls (1.86± 1.67 mg/l) (p <0.0001). The correlations of the two variables, hsCRP and CIMT with H-FABP were both strongly positive (r = 0.687) & (r = 0.779) respectively [both cases (p < 0.0001)].Conclusion:The novel cardiac biomarker H-FAPB might be a good predictor of cardiovascular risks in prediabetics.

Heart-type fatty acid-binding protein (H-FABP), pentraxin-3 (PTX-3) and thrombomodulin in bovine traumatic pericarditis.

The aim of this study was to evaluate the biomarkers of cardiac damage such as heart-type fatty acid-binding protein (H-FABP), pentraxin-3 (PTX-3), and thrombomodulin (TM) for the detection and prognosis of bovine traumatic pericarditis (TP). Spontaneous TP was diagnosed on the basis of history, clinical signs, complete blood count, glutaraldehyde test, ultrasonography, and pericardiocentesis findings. H-FABP, PTX-3 and TM levels in serum were compared between 25 Holstein cows diagnosed with spontaneous TP and 10 healthy control cows using bovine-specific ELISA kits. Serum H-FABP in cattle with TP was significantly (P < 0.05) higher than in the control group and positively correlated with cardiac troponin-I (cTnI), creatine kinase myocardial band (CK-MB), PTX-3 and TM (r = 0.683, 0.342, 0.448 and 0.424, respectively; P < 0.05). The serum levels of PTX-3 (P < 0.05) and TM (P < 0.05) in cattle with TP were significantly higher than in the control group. Cardiac damage biomarkers H-FABP, PTX-3 and TM may be useful in the diagnosis of bovine TP.