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Serum heart-type fatty acid-binding protein concentration positively correlates with the length of aortic dissection
Hiroshi Hazui1, Nobuyuki Negoro, Masayoshi Nishimoto
1Department of Emergency Medicine, Osaka Mishima Emergency and Critical Care Center, Osaka, Japan. hazui112@osaka-mishima.jp
Insights
Elevated heart-type fatty acid-binding protein (H-FABP) in aortic dissection (AD) patients is linked to longer dissections and ascending aorta involvement. This elevation may stem from cardiac, skeletal muscle, or aortic wall release.
Area of Science:
- Cardiology
- Biomarkers
- Aortic Diseases
Background:
- Heart-type fatty acid-binding protein (H-FABP) is often elevated in patients with aortic dissection (AD).
- The clinical significance of this H-FABP elevation in AD remains unclear.
Purpose of the Study:
- To investigate the significance of serum H-FABP levels in patients with aortic dissection.
- To determine factors associated with positive H-FABP tests in AD patients.
Main Methods:
- Serum H-FABP concentrations were measured in 63 AD patients.
- H-FABP positivity was assessed (cutoff: 6.2 ng/ml) and correlated with clinical factors.
- Multivariate logistic regression analyzed factors associated with H-FABP positivity.
Main Results:
- 36 out of 63 AD patients (57.1%) had a positive H-FABP test.
- Positive H-FABP rates were significantly higher in patients with ascending AD (76.7% vs 39.4%, p=0.003).
- A longer dissection length score was significantly associated with H-FABP positivity (p<0.001) and showed a positive correlation with absolute H-FABP values (r=0.420, p=0.001).
Conclusions:
- Increased serum H-FABP in AD patients may originate from cardiac muscle, skeletal muscle, or the aortic wall.
- Physicians should be aware that ascending or long aortic dissections can cause H-FABP elevation, potentially confounding myocardial injury detection.
Background:
Patients with aortic dissection (AD) often demonstrate positive heart-type fatty acid-binding protein (H-FABP), but its significance is unclear.
Methods And Results:
In 63 of 64 consecutive AD patients, the serum H-FABP concentration was measured and the H-FABP positive rate calculated (cutoff value: 6.2 ng/ml) for each of following factors: (1) with or without dissection of the ascending aorta; and (2) a thrombosed false lumen; (3) length score; (4) presence of shock; (5) malperfusion of limbs; (6) ST elevation and/or depression on electrocardiogram; and (7) renal dysfunction. In total 36 AD patients had a positive H-FABP test. Statistically significant differences in the H-FABP positive rate were observed between those with and without ascending AD (76.7% vs 39.4%, p = 0.003), and in the length score (p < 0.001). Multivariate logistic regression test demonstrated that the most significant factor was the length score (odds ratio: 2.239 (95% confidence interval: 1.119-4.481), p = 0.023). Moreover, a significant correlation was observed between length score and absolute H-FABP value (r = 0.420, p = 0.001).
Conclusions:
In patients with AD, an increased serum H-FABP concentration is caused by the protein being released not only from the cardiac muscle but also from skeletal muscle, or possibly the aortic wall. Physicians using H-FABP for detection of myocardial injury need to be aware that patients with a long or ascending AD will show an elevation of H-FABP.
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