血浆心脏型脂肪酸结合蛋白水平与急性失代偿性心力衰竭患者不良预后的相关性分析

目的:探讨急性失代偿性心力衰竭(ADHF)患者血浆心脏型脂肪酸结合蛋白(hFABP)水平与不良预后的相关性。方法:77例ADHF患者在入院和出院时测量血浆hFABP水平,且平均随访(9.2±7.3)个月后,评估达到研究的复合终点(CEP)的患者数。结果:患者出院时血hFABP水平均显著低于入院时,且入院时血浆hFABP水平与左心室重塑的超声心动图参数显著相关。在达到CEP的56例患者(72.7%)中,入院和出院时血浆hFABP水平明显更高。血浆hFABP水平7.8 ng/mL的患者CEP风险较高(对数秩检验,P=0.01)。Logistic逐步回归分析显示出院时血浆hFABP水平、左室射血分数(LVEF)和左心室质量指数独立且显著地预测了CEP(P0.05)。结论:在ADHF患者中,入院时血浆hFABP水平与左心室重塑有关,血浆hFABP水平对不良预后有预测价值,可能反映了持续的心肌损伤。

Correlation between plasma heart type fatty acid binding protein levels and poor prognosis in patients with acute decompensated heart failure

Objective: To investigate the correlation between plasma heart-type fatty acid binding protein (hFABP) and adverse prognosis in patients with acute decompensated heart failure (ADHF). Methods: Seventy-seven patients with ADHF were measured for plasma hFABP concentration at admission and discharge. The subjects were followed up for an average of 9.2±7.3 months, and the patients who reached the compound end point (CEP) of the study were assessed. Results: The median concentration of hFABP at discharged was significantly lower than that at admission. The plasma concentration of hFABP was significantly correlated with echocardiographic parameters of left ventricular remodeling. In 56 patients (72.7%) who reached the CEP, the concentration of hFABP was significantly higher at admission and discharge. Patients with plasma hFABP level higher than 7.8ng/mL had a higher risk of CEP (logarithmic rank test, P=0.01). Logistic stepwise regression analysis showed that hFABP, LVEF and left ventricular mass index at discharge independently and significantly predicted CEP (P<0.05). Conclusion: In patients with ADHF, the admission concentration of plasma hFABP is related to left ventricaular remodeling. The plasma concentration of hFABP has adverse prognostic value and may reflect the persistent myocardial injury.